Commission on Collegiate Nursing Education. DNP Self Study March Narrative

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1 Commission on Collegiate Nursing Education DNP Self Study March 2013 Narrative

2 Table of Contents Introduction and Overview... i Standard I Program Quality: Mission and Governance... 1 Element I-A... 1 Element I-B... 5 Element I-C... 8 Element I-D...11 Element I-E...13 Element I-F...14 Element I-G...15 Standard II Program Quality: Institutional Commitment and Resources...18 Element II-A...18 Element II-B...27 Element II-C...34 Element II-D...36 Element II-E...38 Element II-F...38 Standard III Program Quality: Curriculum and Teaching-Learning Practices...43 Element III-A...43 Element III-B...47 Element III-C...53 Element III-D...54 Element III-E...61 Element III-F...62 Element III-G...63 Standard IV Program Effectiveness: Aggregate Student and Faculty Outcomes...66 Element IV-A...66 Element IV-B...67 Element IV-C...73 Element IV-D...73 Element IV-E...75 Element IV-F...82 References...84 Appendices of Tables...85

3 The University of Texas Health Science Center at San Antonio School of Nursing Introduction and Overview The University of Texas (UT) System was established by the Texas Constitution in It is one of the nation s largest higher education systems and is currently comprised of nine academic universities and six health institutions. The nine-member Board of Regents is the governing body for The UT System ( The Chancellor, Chief Executive Officer of the UT System, reports to the Board of Regents and is responsible to the Board for all aspects of the UT System s operations. The UT System has an annual operating budget of $14.4 billion in sponsored programs funded by federal, state, local and private sources. It confers more than one third of the state s baccalaureate degrees and educates nearly threefourths of the state s healthcare professionals annually. With more than 87,000 employees, the UT System is one of the largest employers in the state. It is responsible for central management and coordination of the multiple campuses and is located in Austin, Texas. The System administration is responsible for managing the Permanent University Fund (PUF) and other endowments, managing university lands, carrying out the Board of Regents policies, collaborating with the Board of Regents on strategic planning, and serving as consultants to the institutions on issues ranging from academic programs to fund raising. As a public institution of higher education, the UT System campuses also work under the direction of the Texas Higher Education Coordinating Board (THECB), which regulates the curriculum and academic policies of state schools ( The University of Texas Health Science Center at San Antonio (UTHSCSA) is one of two UT system campuses located in San Antonio. UTHSCSA was established by state legislation in 1959 with ground-breaking for the actual facilities in 1966 and doors opened in This campus has its own president, William L. Henrich, M.D., M.A.C. P., and financial administrative structure. With a faculty and staff totaling 5,500, the University contributes nearly $1.3 billion to the South Texas economy annually. It is considered to be the catalyst for a $29.2 billion bioscience and health care industry in San Antonio and accounts for approximately 12,000 jobs both on and off campus. The university is committed to make lives better through excellence in education, research, health care and community engagement. Working at the UTHSCSA is all about making lives better ( The Health Science Center is approved by the Southern Association of Colleges and Schools (SACS). i

4 The UTHSCSA is a leading center for research in aging, cancer, cardiovascular diseases, diabetes, and related health disparities. The UTHSCSA serves a 50,000 square mile area of South Texas extending from metropolitan San Antonio to the border communities of the Rio Grande Valley. It is a member of the Hispanic Association of Colleges and Universities (HACU), serves culturally diverse student populations, and is deemed a Hispanic Serving Institution by the US Department of Education. The UTHSCSA campus is located in the northwest San Antonio Medical Center area. The Research Campus is located approximately eight miles from the main campus. There are three extension campuses located in Harlingen, Edinburg, and Laredo, Texas. There are five schools (Medicine, Nursing, Dentistry, Health Professions, and the Graduate School of Biomedical Sciences). In fall 2012, there were 3,310 students enrolled, including 824 nursing students: 600 undergraduates, 180 Master s, 21 PhD, and 23 DNP students. Sixteen (16) percent of nursing students report Hispanic origins, and 23% report other diverse ethnicities, totaling a 39% ethnically diverse nursing student population that is representative of the area served by the SON. The UTHSCSA School of Nursing (SON) was established in 1969 by founding Dean Dr. Margretta Styles. The SON offers four degree programs, an upper division Bachelor of Science in Nursing (BSN) since 1970, the Master of Science in Nursing (MSN) since 1972, the Doctor of Nursing Practice (DNP) since 2012, and the Doctor of Philosophy in Nursing (PhD) since The School of Nursing has the authority to admit, matriculate, and confer degrees for the BSN, the MSN, and the DNP. The Graduate School of Biomedical Sciences (GSBS) has the authority to admit, matriculate and confer PhD degrees for the SON. Therefore, eligible faculty members in the nursing school hold faculty status in the Graduate School of Biomedical Sciences as well as the SON. The School of Nursing was originally part of The UT System SON with campuses in Galveston, Austin, Houston, San Antonio, and El Paso. All five schools followed the same curriculum. In 1976 the System School of Nursing was dissolved and each School of Nursing has since been independent and governed by the university on the campus where the school is located. The UTHSCSA SON baccalaureate and master s degree programs were last accredited by the Commission on Collegiate Nursing Education (CCNE) in the Spring of We are seeking initial accreditation of the new Doctor of Nursing Practice Program. A proposal for a BSN to DNP program was approved by the UTHSCSA in April 2010 and by the UT System Board of Regents in July of Subsequently, the proposal was submitted by the UT System Board of Regents to the Texas Higher Education Coordinating Board (THECB) anticipating their approval for fall Fifteen (15) students began the approved ii

5 coursework (7 BSN and 8 MSN) in awaiting the final approval of the program by the THECB. In October of 2010, the THECB notified the UTHSCSA that BSN to DNP programs would not be considered for approval in the state. Revisions to the initial proposal were made to reflect a Post-MSN to DNP program and the proposal was submitted to the THECB in February A site visit was conducted by the state in July of On January 26, 2012 the program was approved by the THECB. During this process the seven (7) BSN students were transitioned into the existing MSN program. Upon completion of their MSN program, these students would have the option to enter the DNP program without reapplying. The eight (8) MSN students continued in their approved coursework on a part time basis awaiting final approval. Two (2) of the students in this cohort left the program, one (1) moved out of state and the other entered a PhD program. The remaining six (6) students chose to continue on a part time basis with the approved curriculum. In May 2012 five (5) of the six (6) Post MSN students in the initial cohort were officially admitted to the DNP Program. One (1) student decided to complete the Psychiatric Mental Health Nurse Practitioner (PMHNP) Certificate Program and then enter the DNP program after graduation from that program. In fall 2012, eighteen (18) new students entered the DNP program and two (2) of these students took an approved Leave of Absence. Currently, there are 21 students enrolled in the DNP program. The processes and data presented in this self-study represent the program development which began in 2009 and program implementation with admission of the first cohort in January of Data for this time period (where applicable) will be available in the Resource Room. The School faculty has used the self-study process as an opportunity for quality improvement. The self-study process occurred simultaneously with major revisions to the University Strategic Plan. The SON faculty are currently in the process of approving the SON Strategic Plan. Therefore, the self-study was conducted within the context of the newly revised plan. These changes have involved faculty input as well as administrative guidance and both groups remain dedicated to quality educational programs as is reflected throughout the self-study report. The SON serves the four missions of the UTHSCSA: education, research, health care, and community engagement. Eileen T. Breslin, PhD, RN, FAAN was appointed Dean, Chief Executive Officer of the SON in April, This position reports directly to the President of the UTHSCSA ( Since her appointment, Dr. Breslin and iii

6 SON faculty have revised the vision, mission, goals, strategic plan, faculty bylaws, and administrative structure of the school. The SON has a unique role in nursing education related to its placement in the South Texas Region. The region has a large underserved Hispanic population (approximately 58%) with many and significant health care needs. Cardiovascular disease, diabetes, teen pregnancy, mental and other chronic illnesses are prevalent. Many of the nursing students come from a community in which approximately 75% of the population reports High School as the highest educational attainment. Therefore, most students are the first generation to attend college. Faculty educate a diverse student body to become excellent nurses and nurse scientists. Within the past five years, the faculty has revised and implemented both undergraduate and graduate curricula, to reflect the school s mission and vision and strategic goals; to engage our diverse students to produce the future nursing leaders who will lead the transformation of health care to make lives better. In fall of 2012, departmental search committees were constituted. Faculty members are recruiting tenure track and clinical track faculty to facilitate continued growth of the research, education and practice missions. The SON is dedicated to meeting the needs of its communities of interest through each of its core missions. Changes being implemented at the SON reflect the faculty s commitment to innovation in teaching-learning, effective use of available resources and programs as well as fostering safe quality health care through research and practice/service. This report will provide data indicating the extent to which the SON has been able to effectively meet the standards of accreditation as it relates to the Doctor of Nursing Practice Program. iv

7 Standard I Program Quality: Mission and Governance The mission, goals, and expected aggregate student and faculty outcomes are congruent with those of the parent institution, reflect professional nursing standards and guidelines, and consider the needs and expectations of the community of interest. Policies of the parent institution and nursing program clearly support the program s mission, goals, and expected outcomes. The faculty and students of the program are involved in the governance of the program and in the ongoing efforts to improve program quality. I-A. The mission, goals, and expected student outcomes are congruent with those of the parent institution and consistent with relevant professional nursing standards and guidelines for the preparation of nursing professionals. Elaboration: The program s mission statement, goals, and expected student outcomes are written and accessible to current and prospective students. A mission statement may relate to all nursing programs offered by the nursing unit or specific programs may have separate mission statements. Program goals are clearly differentiated by level when multiple degree programs exist. Expected student outcomes are clear and may be expressed as competencies, objectives, benchmarks, or other language congruent with institutional and program norms. The program identifies the professional nursing standards and guidelines it uses, including those required by CCNE and any additional program-selected guidelines. A program preparing students for specialty certification incorporates professional standards and guidelines appropriate to the specialty area. A program may select additional standards and guidelines (e.g., state regulatory requirements), as appropriate. Compliance with required and program-selected professional nursing standards and guidelines is clearly evident in the program. Program Response The University of Texas Health Science Center, hereafter UTHSCSA, is a free standing academic health science center in San Antonio, Texas which plays a major leadership role in healthcare for all of South Texas. The latest mission, vision, and values statements for UTHSCSA were approved by the UT Board of Regents on November 10, 2011 and by THECB on April 25, The UTHSCSA is in the final stages of adopting a new strategic plan for the University (See Appendix I, Table I-A-1, The Strategic Planning Process Calendar of Events. The SON s vision, mission, and goals are each congruent with those of the UTHSCSA and are consistent with relevant professional standards and nursing guidelines preparing students for beginning and advanced nursing practice. Both are accessible to current and prospective students. The UTHSCSA mission, values and vision statements are written and published on the UTHSCSA web site ( The School of Nursing (SON) mission, vision and values statements are written and published on the 1

8 SON web site and relate to all academic programs. The SON strategic plan is available on the website ( and the newly revised strategic plan is available in the Resource Room (Standard I-A-2, SON Strategic Plan). It is anticipated that the newly revised strategic plan will be approved by faculty at its Faculty Assembly meeting on February 22, 2013 and will be posted on the web site immediately following approval. The Doctor of Nursing Practice (DNP) program, has developed program specific goals and expected student learning outcomes. The goals and the expected student outcomes of the DNP program are related to the mission and goals of the UTHSCSA and SON. Table 1-A-1, represents a comparison of the UTHSCSA mission and goals, the SON mission and goals and the DNP program goals. Table 1-A-1, Relationships between the UTHSCSA Mission and Goals, the SON Mission and Goals and the DNP Program Goals. UTHSCSA Mission School of Nursing Mission Make lives better through excellence in education, research, health care and community engagement. We engage with our diverse students and communities to produce the future nursing leaders who will lead the transformation of health care to make lives better through education, research, practice and community engagement. UTHSCSA Goals School of Nursing Goals DNP Program Goals Educating a diverse student body to become excellent health care providers and scientists. Engaging in research to understand health and disease, and to commercialize discoveries, as appropriate, to benefit the public. Providing compassionate and culturally proficient health care, and influence thoughtful advances in health policy. Engaging our community to improve health. Striving for excellence, innovation, quality and professionalism in an effective and efficient manner. Educate a diverse student body to become excellent nurses and nurse scientists. Engage in research to increase knowledge about health and disease and health care delivery and to commercialize discoveries beneficial to the public Provide exemplary, innovative, culturally proficient nursing care to our local and global communities. Make a significant impact on the health of our local and global community. Provide an effective, efficient and culturally proficient infrastructure which embodies innovation, quality and professionalism to support faculty, staff and students as they fulfill the mission of the School of Nursing. 2 Prepare graduates for the highest level of advanced specialized nursing practice to assume leadership roles in providing and promoting excellence in patient care and public health Translate and apply knowledge to manage complex health problems and effect changes in the systems of care to promote safe, timely, effective, efficient, equitable and patient-centered care. Prepare graduates to partner in improving health outcomes of the community through the interprofessional collaboration and consultation with health care professional teams.

9 The development of student learning outcomes for the DNP program was guided by the current American Association of Colleges of Nursing (AACN) Essentials of Doctoral Education for Advanced Nursing Practice (2006) document and build on advanced nursing practice guidelines for the specific tracks. Upon completion of the DNP program graduates are expected to: 1. Integrate nursing science, ethics, bio-physical, psychosocial, analytical, and organizational sources to provide the highest level of specialty nursing practices. 2. Develop, implement, and evaluate healthcare practices in healthcare systems that ensure quality improvement and patient safety. 3. Use analytic methods and evidence-based practices to improve practice outcomes and the practice environment. 4. Implement and evaluate ethical healthcare information systems and patient care technology to improve the quality of patient health outcomes and care systems. 5. Advocate for healthcare practices that advance social justice, equity, and ethical policies within all healthcare arenas. 6. Employ inter-professional collaborative teams to improve patient and population health outcomes and healthcare delivery systems. 7. Lead the integration and institutionalization of (evidence-based) clinical prevention and population-based health guidelines. 8. Use clinical judgment, systems thinking, accountability, and specialized knowledge to design, deliver, and evaluate evidence based, culturally proficient care to improve patient, population, and health systems outcomes. The program level goals, program outcomes, and specific track level student learning outcomes are published and accessible in the DNP Student Handbook. Congruence of University, School of Nursing, and Program The SON s mission, vision, and values were reviewed and revised by faculty during the spring and fall of 2012 through small working group meetings, with leadership being provided by the Faculty Council, Committee Chairs, and respective administrators working together to create the new strategic plan in line with the UTHSCSA new plan. The revisions reflect current and future shared goals of SON faculty in regard to the three missions: education, research, and practice and community engagement. The SON mission is We engage with our diverse students and communities to produce the future nursing leaders who will lead the transformation of health care to make lives better through education, research, and practice and community engagement. The mission statement is purposely broad and reflects congruence with the UTHSCSA. 3

10 The new Strategic Plan for the UTHSCSA identifies university level goals, objectives and outcome measures and may be reviewed in the Resource Room, Standard I-A-1, Strategic Plan for UTHSCSA. The new SON Strategic Plan, also available in the Resource Room, Standard I-A-2, SON Strategic Plan , provides a framework for accomplishing the SON goals, related to each of the four missions of teaching, research, health care and community engagement. The SON Strategic Plan is pending final approval by faculty vote to occur on February 22, 2013 and will be used to guide strategic initiatives, while also undergoing review to meet the ongoing SON needs (Resource Room, Standard 1-A-2 Faculty Assembly Minutes). At the writing of this self- study, the SON faculty and administration are currently engaged in prioritizing strategic initiatives for each goal and identifying funding requirements. The next step, planned for completion March 31, 2013, is to identify the activities, metrics and timelines for each strategic initiative for each goal. Consistency of Professional Standards and Program Outcomes The SON educational strategy under the teaching goal is to educate a diverse student body to become excellent nurses and nurse scientists. To achieve this objective, current expected student learning outcomes for the program were crafted based on the most current Essentials of Doctoral Education for Advanced Nursing Practice (American Association of Colleges of Nursing (AACN), 2006). In the AACN Essentials of Doctoral Education for Advanced Nurse Practice, advanced nursing practice has been defined as having direct and indirect foci: direct care of individuals or indirect care at the aggregate, system or organizational level. The Nurse Practitioner Leadership track (direct care) was guided by the Domains and Competencies of Nurse Practitioner Practice (National Organization of Nurse Practitioner Faculty (NONPF), 2012) and Criteria for Evaluation of Nurse Practitioner Programs (NTF, 2012); the Executive Administrative Management track (indirect care) by the American Organization of Nurse Executives (AONE) Nurse Executive Competencies (AONE, 2006) and the Public Health Nurse Leader track (indirect care) by the Core Competencies for Public Health Professionals (The Council on Linkages Between Academia and Public Health Practice, 2010) and the Quad Council Competencies for Public Health Nurses (Quad Council, 2011). Because this is a post-master s entry, the AACN Essentials of Master s Education (2011) informed baseline standards as well. Additional resources that identify competencies in areas specific to the essentials of education documents were also consulted in preparing curricula. These documents include the Quality and Safety Education for Nurses competencies (QSEN) ( and the Technology Informatics Guiding Education Reform competencies (TIGER) competencies ( Tiger-Competencies-info). 4

11 I-B. The mission, goals, and expected student outcomes are reviewed periodically and revised, as appropriate, to reflect: professional nursing standards and guidelines; and the needs and expectations of the community of interest. Elaboration: There is a defined process for periodic review and revision of program mission, goals, and expected student outcomes. The review process has been implemented and resultant action reflects professional nursing standards and guidelines. The community of interest is defined by the nursing unit. The needs and expectations of the community of interest are reflected in the mission, goals, and expected student outcomes. Input from the community of interest is used to foster program improvement. The program afforded the community of interest the opportunity to submit third-party comments to CCNE, in accordance with accreditation procedures. Program Response A defined process exists for periodic review and revision of the program mission, goals, and expected student outcomes. The process is outlined in the SON Total Program Systematic Evaluation Plan (TPSEP) which was approved and implemented by Faculty Council initially on September 21, Ongoing review has resulted in revisions, the most recent, during the academic years. The document is available in the Resource Room, Standard I-B-1, Total Program Systematic Evaluation Plan. The evaluation component is specified for each CCNE standard and key elements consistent with CCNE accreditation evaluation criteria. For each component there is an identified specific expected outcome, specified evaluation data, identified responsible agent for collection and analysis of data, a collection schedule, the actual outcome, an action plan, a result, and specification of where documents are located. Anyone who has access to the website has access to the evaluation plan. This TPSEP was approved through SON bylaws structure and implemented during the academic year. Revisions have been made to the TPSEP as quality improvement discussions occurred. Revisions are available in the Resource Room, Standard I-B-2 Revisions to the TPSEP. The Faculty Council reviews elements under specific standards. For example, Standard I, Program Outcome 1.3 states the mission, goals and student outcomes are reviewed periodically and revised as appropriate to reflect professional nursing standards. The standard was discussed in Faculty Council on September 19, Individual members of the council were assigned a specific goal to review and to present findings at subsequent Faculty Council meetings (Resource Room, Standard I-B-3, Faculty Council Minutes). Since the last accreditation site visit in 2011, the University embarked on a new strategic planning process. The Faculty Council conducted an extensive review of the progress of the SON in achieving its goals in the Strategic Plan of Faculty Council minutes reflect the 5

12 review of the goals. A summary of the strengths, weaknesses, opportunities and threats (SWOT) analysis conducted by faculty council members is available in the Resource Room, Standard I-B- 4, SWOT Analysis. All other standards have and continue to be reviewed on a regular and recurring basis. For example, outcome 2.1 states that fiscal and physical resources are sufficient to enable the program to fulfill its mission, goals and expected outcomes. A comprehensive review of classroom and information technology occurred during the strategic planning process which has enabled the school to quantify the necessary physical improvements needed and to upgrade classrooms such as improved Wi-Fi throughout the nursing school (physical space upgrades are discussed in greater detail under Standard II-A-1, Physical Resources). The Committee on Graduate Studies (COGS) is responsible for monitoring student outcome data annually. COGS has reviewed aggregate student outcomes and proposed substantive revisions to graduate curricula. Formative evaluation is ongoing concurrent with implementation of the new DNP curriculum. COGS minutes are available in the Resource Room, Standard I-B-5, COGS Minutes. The Needs and Expectations of the Community of Interest Students, faculty, and healthcare consumers in the South Texas region are all core constituencies included in the SON defined Community of Interest (COI) although, the actual SON definition is much broader to be consistent with the mission of the SON and the UTHSCSA. The SON defined its Community of Interest (COI) as groups and individuals who have an interest in the mission, goals, and expected outcomes of the SON and its effectiveness in achieving them. The definition was drafted by Faculty Council (December 14, 2009) and approved by the Faculty Assembly on April The model depicting the COI is displayed in Figure I-B-1, SON Community of Interest and is available in the Resource Room, Standard I-B-6. 6

13 The diverse student body described in the introduction reflects the ethnically diverse population of San Antonio and South Texas (58%) and is evidenced in the COI definition and the SON mission. The education and research goals identify the students and communities we serve as the target population for leading edge research learning environments. Other goals address the specific health risk reduction and promotion needs of a population with significant chronic illness and health vulnerability issues. The goal for health care and community engagement states that services will be provided throughout our local and global communities. Efforts to increase the presence of nurses in community based clinics, school systems, and other areas evidence the SON s commitment to making lives better by providing expert, safe, and quality care. During the curriculum revision and review processes (discussed in greater detail under Standard III, Key Element D) information from the COI was used to identify appropriateness of extant programs and planning for new or expanded programs. For example, both formal and informal meetings were held with key stakeholders in developing plans for implementing the new DNP program. The SON is fortunate to have the assistance of the Nursing Advisory Council (NAC), a group of stakeholders who have functioned as a link between the SON and the community since Members include business executives, nurses, and the wives of the UT System Chancellor and UTHSCSA president. The group serves in advisory and advocacy capacities for the SON. They see themselves as the bridge to the community, generating financial resources, influence, awareness, and partnerships that enhance and support the UTHSCSA SON and baccalaureate and higher education for nurses. This group has been particularly active in raising funds for building improvements and participated in political activities in Spring of 2011 during the biannual session of the Texas Legislature. For the first time ever, NAC members spent a full day interacting with the state legislators to educate them on the importance of baccalaureate education. The NAC committee members are committed to doubling their efforts to advocate on our behalf during this legislative session in Documents explaining the NAC history, strategic goals, and initiatives are available in the Resource Room (Standard I-B-7, Nursing Advisory Council). The examples provided above reflect activities more focused on proximal COI populations. Other activities have moved to national and international COI populations and environments to further foster program improvement. The Dean, Department Chairs and faculty made several trips to Thailand and Australia to learn about innovations in clinical education, to foster faculty and student exchange opportunities, and to develop research and practice and community engagement initiatives. New academic and clinical relationships are being developed 7

14 as a result of these international travels which will facilitate ongoing program improvement, diversity, and development. In September 2012, faculty from the University of Michigan, UTHSCSA and faculty and students from the University of Nuevo Leon (UNL) in Monterey, Mexico interacted for 2 days regarding chronic disease management. As a result, one student from UNL is currently pursuing graduate education at our School. Within the past year, six (6) formal memorandums of agreement (MOA) have been finalized. The MOAs are available for review in the Resource Room, I-B-8, International Memorandums of Agreement. In anticipation of the CCNE accreditation site visit, the program notified the COI via the web site ( letters to specific constituencies, telephone, and personal communication to inform them of the imminent accreditation visit and to invite third party comments to CCNE up until 30 days before the site visit. Communications included the name and mailing address of CCNE. Copies of these communications are available in the Resource Room, Standard I-B-9, Solicitation of Third Party Comments. I-C. Expected faculty outcomes in teaching, scholarship, service, and practice are congruent with the mission, goals, and expected student outcomes. Elaboration: Expected faculty outcomes are clearly identified by the nursing unit, are written, and are communicated to the faculty. Expected faculty outcomes are congruent with those of the parent institution. Program Response Expected aggregate faculty outcomes are clearly identified as outcome measures associated with each specific goal listed in the Strategic Plan. They are communicated for all faculty via the SON Strategic Plan. Since faculty goals emanate from the SON mission, they are congruent with expected faculty outcomes of the UTHSCSA, the parent institution. A major faculty bylaws change occurred the Spring 2012 semester with the adoption of Departmental Promotion and Tenure Committees for the two departments within the School. A Departmental committee structure to initiate review of promotion and tenure packets is in line with the UTHSCSA policies and procedures. The faculty bylaws delineate the specific work of the Departmental and School committees. This fall Departmental Promotion and Tenure Committees began their work. Faculty bylaws are available for review by all at under faculty bylaws in the menu on the right. The SON Promotion and Tenure Advisory Committee (PTAC) follows the process for assessing achievement of individual faculty outcomes outlined by UTHSCSA protocols and guidelines. Therefore, the evaluation process and granting of rank and tenure is congruent with the protocols and guidelines of the parent institution. Expected faculty outcomes of UTHSCSA 8

15 tenure and non-tenure track faculty are dictated for each rank and can be found on the UTHSCSA home page under Faculty Resources ( The initial review for appointments and dossiers for promotion and/or tenure at or above the level of Associate Professor occurs at the departmental level. Departmental committees also guide, coach, and mentor faculty from initial appointment through promotion and/or tenure. The SON PTAC ensures consistency in the application of criteria and adherence to UHSCASA policy and procedures. The SON employs faculty on both the tenure and non-tenure (clinical) tracks. According to UTHSCSA policy, tenure track faculty must be appointed at the assistant professor rank or higher, unless otherwise approved by the Dean. Qualifications are specified for each faculty rank in regard to scholarship and are published in the Handbook of Operating Procedures, Chapter 3.6 Guidelines for Establishing Rank and Tenure ( Both tenure and non-tenure track faculty are expected to meet scholarly outcomes in the area of teaching and, if tenure track, in one other area, research (discovery or application) or service (practice/engagement). Each component of scholarship is clearly defined in the PTAC Scholarship document (Resource Room, Standard I-C-1, PTAC document). Faculty with DNP degrees may enter either track. Scholarship in nursing is defined as those activities that systematically advance the teaching, research, and practice of nursing through rigorous inquiry that: 1) is significant to the profession; 2) is creative; 3) can be documented; 4) can be replicated or elaborated; and 5) can be peer-reviewed through various methods (AACN, 1999,p.3). UTHSCSA definitions of scholarly areas are broadly defined, while the SON documents specify scholarship as it pertains to the nursing domain. The scholarship of teaching addresses application of competencies related to effective transfer of knowledge with a focus on promoting development of educational environments that embrace diverse learning styles, and increasingly, places the focus of education on the learner, evaluation, and program development (Chapter 3, Teaching Scholarship, Section 3.3.2c). Discovery scholarship focuses on knowledge discovery and dissemination, while practice/community engagement scholarship focuses on clinical care and competent practice (Chapter 3, Discovery, Section 3.3.2b). The scholarship of application/practice encompasses all aspects of the delivery of nursing service where evidence of direct impact in solving health care problems or in defining the health problems of a community is presented (Chapter 3, Application/Practice Scholarship, Section 3.3.2d). A copy of the Guidelines for Establishing Rand and Tenure and Policies and Procedures Regarding Tenure can be found in the UTHSCSA Handbook of Operating Procedures (HOP), Chapter 3.6 and 3.7. A copy is available in the resource room. (Resource Room, Standard I-C-2, Consideration for Promotion and Tenure) 9

16 Promotion and tenure guidelines are communicated to faculty through published documents on the website ( (Chapter 3.6), and/or via communication with the department, school and the university promotion and tenure committees. Each year the university hosts promotion and tenure (P & T) workshops specifically based on rank and track. Individuals seeking promotion and/or tenure select the program to attend based on their specific need. The UTHSCSA has sponsored annual P & T workshops across all schools in order to familiarize faculty with the P & T guidelines. The ultimate goal of the workshop is to facilitate mentorship of faculty seeking promotion and/or tenure. In addition, the SON hosts P & T information meetings for all faculty on a regular basis. The SON publishes a perpetual calendar, which clearly delineates, month by month the applicant s responsibilities or activities that must be undertaken to complete the promotion and tenure process in a timely manner. The SON Department PTAC also helps faculty with the mid-probation review (5 th year of the 9 year tenure track) process, promotion and/or tenure, and post tenure review (every five years) (UTHSCSA SON Faculty Handbook, Section 3.4, Page 1-3). Tenure-track faculty are required to participate in mid-probationary review to facilitate assessment of progress toward promotion and tenure goals. Also, the SON Department PTAC offers assistance to faculty as they prepare their promotion and tenure documents. Members of that committee mentor faculty through the process of obtaining supporting materials and preparing their packet. Each department also assists faculty with maintaining their electronic curriculum vitae and assembling promotion packet materials. Examples of recent publications, funded grants, and teaching projects are available in the Resource Room (Standard I-C-3, Faculty Teaching and Scholarship). SON faculty teaching workload expectations related to teaching are regulated by the UT System Board of Regents. Currently, the SON chairs are using the guidelines for academic institutions as specific guidelines for health related institutions have not been developed (Resource Room, Standard I-C-4, The University of Texas System Rules and Regulations of the Board of Regents, Rule: Academic Workload Requirements). One SCH of graduate didactic instruction equals 1.5 WLC and graduate clinical instruction is awarded WLC at 1:1 ratio for weekly contact hours. Adjustments are made for clinical practicum, large class sizes, other assigned duties, and for funded research projects. Resource Room, Standard I-C-5 depicts faculty WLC. The UT System and the UTHSCSA are currently examining performance measures as they relate specifically to the Health Related Institutions (HRI). The Dean was asked to represent UTHSCSA at a meeting of the UT System in September where the conversation started to unfold the complexity of the issue. Currently, the SON Vice Dean 10

17 serves on the committee looking at clinical performance measures for the UTHSCSA. The VP for Academics is convening UTHSCSA faculty members to examine the teaching mission and the Vice President for Research has engaged faculty for examining research metrics. Conversations about workload are occurring as we write this self-study. The SON Department Chairs have engaged a working group of nursing faculty to examine workload issues within the context of the University conversation. For example, workload discussions pertaining to DNP faculty include amount of effort for directing the Inquiry Project. The two Department Chairs apply the teaching workload formula to assure fairness and equity in teaching workload and to assure faculty success in meeting current guidelines apropos to promotion and/or tenure. Tenure track faculty should have a minimum of 18 teaching workload credits during each nine month academic year. The expectation is higher, approximately 24 credits, for non-tenure track faculty, since they have only one primary focus. Workload exceptions are allowed at the discretion of the Department Chair to facilitate success in achieving individual faculty goals. The Program Directors and Associate Dean for Academic Affairs work cooperatively and collaboratively in drafting the academic schedule of courses. They submit the programmatic teaching needs to the department chairs for the academic year. Faculty submit their preferences for teaching to the department chairs. This process is an iterative process with communication among them all. For example, DNP faculty requested teaching assignments within the DNP program based on their knowledge, skills and abilities. Courses have been cotaught in the DNP program to begin to provide depth and mentorship to the faculty. I-D. Faculty and students participate in program governance. Elaboration: Roles of the faculty and students in the governance of the program, including those involved in distance education, are clearly defined and promote participation. Program Response The roles of faculty and students in governance of the program are clearly defined in the SON Faculty Bylaws, and are posted on SON website under administration and are available in the Resource Room (Standard I-D-1, SON Faculty Bylaws). The SON, in keeping with UT System Board of Regents requirements and the UTHSCSA bylaws, has both a Faculty Council and Faculty Assembly. The Faculty Council is comprised of the Dean, Associate Deans, Department Chairs, the Faculty Assembly officers, Chairs of each standing committee, and the Directors of each of the SON Centers. The Faculty Council has authority to oversee school policy implementation. Members of the Faculty Council consult and advise the Dean and forward policy suggestions to the Faculty Assembly. The Faculty Assembly has the authority to establish school policies which guide: all curriculum offerings, scholarship and 11

18 practice/community engagement activities; recruitment, selection, admission, promotion and well-being of students; selection, appointment, promotion, and well-being of faculty; and collaboration in the development and implementation of the systematic evaluation plan. There are six SON standing committees and three special committees identified in the bylaws. The roles and responsibilities of each committee are clearly defined for faculty and students who participate in those committees. Membership on each committee is also specified and the duties of the committee members and the Chair are listed. The roles of faculty in school governance are also clearly articulated in the SON Bylaws. Voting members of Faculty Assembly are faculty members with at least 0.5 FTE appointments for a full academic year. Faculty members are eligible and encouraged to serve on the UTHSCSA and UT System committees. There is an overall UTHSCSA Committee on Committees (COC) that serves as the facilitator for placing faculty members on each of the University Committees ( Each year the COC meets to review the purpose, membership, and functions of each UTHSCSA committee. Terms of office are generally two years, with rotating vacancies filled each year. Faculty are notified by a representative from their school about vacancies and encouraged to self-nominate for those committees that are most suited to their level of expertise. Nominations are compiled by the COC and university elections held to fill vacancies. Each school s Faculty Assembly elects faculty members to serve as faculty senators on Faculty Senate ( The Faculty Senate provides a forum for faculty to discuss and address issues affecting their rights and privileges, responsibilities, and welfare. The Senate provides representation for University Faculty so as to ensure that every member of the Faculty has a voice regarding issues that may affect his or her rights, privileges, responsibilities, and welfare regarding the teaching, research, and clinical programs and services of the UTHSCSA (Faculty Senate, 2010). Students are members of four of the six standing committees: Committee on Undergraduate Studies (COUS-one student member from each track of the undergraduate program), Committee on Graduate Studies (COGS-one MSN student and one PhD student member), Committee on Faculty and Student Matters (three undergraduate and two graduate students elected from each of the student organizations [NSNA and GNSA]), and the Committee on Scholarship (one doctoral student). Students participating on each committee have both voice and voting rights which promotes participation. The faculty bylaws were amended at the Faculty Council meeting held on January 14, 2013 to include a DNP student on COGS and are pending approval by Faculty Assembly. The Associate Dean for the Office of Admissions and Student Services (OASS) solicited current DNP students and the student representative position was identified and is awaiting final approval. The remaining committees: 12

19 Promotion and Tenure Advisory Committee, The Committee on Faculty Practice/Engagement, and the three Special Committees (Search, Bylaws, and Nominations) do not have student representatives due to the nature of their responsibilities. Since the DNP program is a professional degree program, the oversight is through the School of Nursing governance process, specifically, COGS. Faculty leadership is provided by the Program Director who engages the faculty teaching in the program on a monthly basis for ongoing program development. The Program Director initiates policies and procedures for the DNP and takes them for action through COGS, Faculty Council and Faculty Assembly (Minutes of these Committees are available in the Resource Room, Standard I-B-5, COGS Committee Minutes, I-B-3, Faculty Council Minutes, and I-A-2, Faculty Assembly Minutes). With the development of the strategic plan, a reexamination of the structure of COGS is currently being undertaken. Oversight of the DNP program resides with the DNP Program Director (Resource Room, Standard I-D-4, DNP Program Director Job Description). The Associate Dean for Academic Affairs is responsible for ensuring appropriate communication occurs from the School of Nursing to the Office for Academic, Student and Faculty Affairs. Nursing students actively participate in UTHSCSA committees, including the UTHSCSA student government association. In April 2010, nursing and medical students initiated a local chapter of the Institute on Health Improvement Open School on the UTHSCSA campus. Students from Trinity University School of Health Care Administration also collaborated in development of this organization. Two students, one from the SON and another from the School of Health Professions participated in the 22 nd Annual IHI National Forum, representing the UTHSCSA chapter at the Open School Chapter Forum and presenting a poster at the poster session. I-E. Documents and publications are accurate. References to the program s offerings, outcomes, accreditation/approval status, academic calendar, recruitment and admission policies, transfer of credit policies, grading policies, degree completion requirements, tuition, and fees are accurate. Elaboration: A process is used to notify constituents about changes in documents and publications. Information regarding licensure and/or certification examinations for which graduates will be eligible is accurate. Program Response The SON goal is complete accuracy for all SON documents pertaining to program offerings, program outcomes, accreditation status, academic calendars, recruitment policies, admission policies, transfer credit policies, grading policies, degree completion requirements, tuition and fees. Systems are in place to assure that documents and publications such as the UTHSCSA Catalog, Website, Faculty Handbook, Strategic Plan, and Total Program Systematic 13

20 Evaluation Plan are correct and updated regularly. There is a process for annual updates to be posted to the UTHSCSA Catalog. However, there has been a major change in personnel in the Registrar s Office and no catalog is posted for The DNP Handbook was developed to house pertinent academic policies related to the curriculum, admission, and progression. The SON website is currently being redesigned for clarity and usability for students under the direction of a new position specifically for this purpose. A major revision of the web site had been undertaken in Now that the web architecture is present, it is more easily adapted and needs regular monitoring. This position was created in 2012 to address this need for SON web oversight. The job description is in Resource Room, Standard I-E-1, Job Description. The entire UTHSCSA website is also under revision with Vice Dean for SON, Julie Novak, serving on the UTHSCSA Web Task Force. The evaluation criteria and grading policies for each course are published in the syllabus of each course and posted on the UTHSCSA website Table I-E-1, Sample Policies in Effect for DNP Applicants and Students Policy and Source outlines selected policies and the source of the policy whether in the UTHSCSA or SON Table I-E-1, Sample Policies in Effect for DNP Applicants and Students Policy and Source Policy Program Offering Syllabi Outcomes Accreditation Status Academic Calendar Admission Requirements Transfer of Credit Grading Policy Academic Probation Degree Completion Tuition and Fees Comment and Source I-F. Academic policies of the parent institution and the nursing program are congruent. These policies support achievement of the mission, goals, and expected student outcomes. These policies are fair, equitable, and published and are reviewed and revised as necessary to foster program improvement. These policies include, but are not limited to, those related to student recruitment, admission, retention, and progression. Elaboration: Nursing faculty are involved in the development, review, and revision of academic program policies. Differences between the nursing program policies and those of the parent institution are identified and are in support of achievement of the program s 14

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