Commission on Collegiate Nursing Education. DNP Self Study March Narrative

Transcription

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

21 mission, goals, and expected student outcomes. Policies are written and communicated to relevant constituencies. Policies are implemented consistently. There is a defined process by which policies are regularly reviewed. Policy review occurs and revisions are made as needed. Program Response Academic policies have traditionally been reviewed annually. Currently, there is a new Vice President for Academic, Faculty, and Student Affairs who is undertaking a comprehensive review of all Handbook of Operating Procedure (HOP) policies in preparation for the upcoming Southern Association of Colleges and Schools (SACS) Accreditation. The SON Associate Dean for Academic Affairs is a member of the University-wide SACS Accreditation Working Group and is currently reviewing SON academic policies to ensure congruence with UTHSCSA policy. In some cases, SON policies differ in instances when regulatory requirements are more stringent for nursing programs than would be considered necessary for the general student population. For example, the dismissal policy for the graduate program has been tightened and students are dismissed after earning one failing grade. Another example is that each school follows a different process and policy regarding criminal background checks (CBC). SON policy requires that applicants complete and have a clear CBC before being matriculated into the nursing program; this policy is congruent with Texas Board of Nursing (TBON) and clinical agency requirements. In summary, policies related to student recruitment, admissions, retention, and progression are revised as needed to maintain congruency with UTHSCSA policy. The Committee on Graduate Studies (COGS) is responsible for development of graduate student recruitment, admission, retention and progression policies and procedures within the SON in concert with the Associate Dean for Academic Affairs and the Associate Dean for Admissions and Student Services. In addition, each School in the UTHSCSA has designated representation on University Committees that are responsible for review and development of policies and procedures including the Uniform Recruitment and Retention Committee (URRS) and the Student Health Advisory Committee. Associate Deans from all schools meet at regular intervals with the Vice President for Academic, Faculty, and Student Affairs to review and revise policies that affect all schools in the UTHSCSA, and to ensure that policies and procedures are consistent with those required by state and federal law and with University regulations. I-G. There are established policies by which the nursing unit defines and reviews formal complaints. Elaboration: The program s definition of a formal complaint and the procedure for filing a complaint are communicated to relevant constituencies. The program follows its established policies/procedures for formal complaints. 15

22 Program Response The policies for reviewing complaints within the SON are consistent with those of the University s Academic Review Policy and are published in the UTHSCSA Catalog for students under the heading Student Grievance Procedures (p. 34 for UTHSCSA; p. 401 for SON; (Resource Room, Standard I-G-1, University Catalog). These policies relate to academic integrity and challenging grades through academic review. According to the UTHSCSA policy, the Dean of the school in which the student is enrolled has jurisdiction over the student s program of study, degree requirements, and all other academic matters, including grievances (UTHSCSA Catalog, , p. 34). These sections include both policies and processes for communicating and resolving student concerns. Issues that may be addressed include Student Appeals and Grievances (academic and non- academic), Procedure for Academic Review, Composition and Function of the Academic Review Committee, Conduct of the Academic Review Committee Hearing, and Procedure for Second Readers of Papers. As stated in Standard I F, the SON Associate Dean for Academic Affairs is a member of the University-wide SACS Accreditation Working Group and is currently reviewing SON academic policies to ensure congruence with UTHSCSA policy. If students have concerns which are non-academic but are not discriminatory in nature, the established policy and procedures for informal complaints of non-academic discrimination is followed, as described in the UTHSCSA catalog. If students are not satisfied with an outcome related to a concern, they have the option to appeal through a formal grievance process to the Dean. In addition to the policies and procedures related to concerns addressed above, there are offices within the UTHSCSA that deal specifically with concerns such as the office of Equal Employment Opportunity (EEO), or ethical issues (the Ethics Hotline). The EEO office also helps with resolution of Americans with Disabilities Act issues. Strengths The SON has a strong faculty governance structure that allows faculty to actively participate in achievement of SON mission and goals, as well as facilitating achievement of program outcomes for both faculty and students. Students are fully engaged in the SON, actively participating in COGS. They attend meetings, and are vocal, contributing members of the committees helping to assure that student needs are met. The SON is supported by a strong Nursing Advisory Committee. This group facilitates achievement of the school s mission through its links to the community. An excellent collaborative relationship within and among community of interest constituencies ensures achievement of mission and goals, especially between the SON and the 16

23 major clinical partners. These partnerships help to assure the relevance of the educational enterprise. Opportunities for Improvement The SON is continuing to fully implement and evaluate the effectiveness of both the evolving Strategic Plan and the Total Program Systematic Evaluation Plan. Action Plan: The SON will continue to monitor the implementation of both the Strategic Plan and the TPSEP evaluating existing organizational structures and procedures. 17

24 Standard II Program Quality: Institutional Commitment and Resources The parent institution demonstrates ongoing commitment and support for the nursing program. The institution makes available resources to enable the program to achieve its mission, goals, and expected aggregate student and faculty outcomes. The faculty, as a resource of the program, enables the achievement of the mission, goals, and expected aggregate student outcomes. II-A. Fiscal and physical resources are sufficient to enable the program to fulfill its mission, goals, and expected outcomes. Adequacy of resources is reviewed periodically and resources are modified as needed. Elaboration: The budget enables achievement of the program s mission, goals, and expected student and faculty outcomes. The budget also supports the development, implementation, and evaluation of the program. Compensation of nursing unit personnel supports recruitment and retention of qualified faculty and staff. Physical space is sufficient and configured in ways that enable the program to achieve its mission, goals, and expected student and faculty outcomes. Equipment and supplies (e.g., computing, laboratory, and teaching-learning) are sufficient to achieve the mission, goals, and expected student and faculty outcomes. There is a defined process for regular review of the adequacy of the program s fiscal and physical resources. Review of fiscal and physical resources occurs and improvements are made as appropriate. Program Response Strategic planning serves as the mechanism to enhance quality and vitality, communicate an organizational purpose and priorities, and identify opportunities and new directions for the institution. The faculty, staff, students and administrators are always included in the process of planning. The budget evolves as the blueprint for implementation of the strategic plan (see Resource Room II-A-1, Strategic Plan Priorities and Funding Requirements). Resource management is organized through two processes: 1) the state annual budget request and 2) a capital improvement plan. The School of Nursing (SON) continues to respond to the critical need for faculty by increasing graduate enrollment. The undergraduate nursing student enrollment targets have not increased in the past year. The SON is actively addressing the decline in Nursing Faculty in the state by expanding enrollment in the MSN, DNP and PhD Programs. Budget Each year, the Associate Deans, Chairs and Directors participate in a budget resource planning (BRP) meeting with the Dean and the Assistant Dean for Administration to present the status of their areas resources. They identify budgetary needs, staffing needs, goals and objectives and ideas for income streams that will allow accomplishments of goals and objectives 18

25 in full alignment with the strategic plans of the UTHSCSA and the SON as depicted in Appendix II, Table II-A-1, UTHSCSA Budget Timeline. Tuition and fees are reviewed on an annual basis (September-October) to allow for assessment of designated tuition and student fees. The review ensures all revenue is sufficient to cover maintenance, operation, and replacement of computers; IT support; graduate counseling fees; graduate portfolio fees; and costs of other resources used by faculty to provide instructional services to students. This year, because of the concern for student financial burden, no increase in student fees has been entertained by the UT System. The UTHSCSA provides fiscal resources from state appropriations to support the education, research, health care and practice/community engagement missions of the SON based on an annual budget request submitted by the Dean to the President, Chief Operating Officer, and Chief Business Officer. Selected initiatives for the School of Nursing may be funded through a variety of other UT System sources such as grants for new faculty through the STARS (Science and Technology Acquisition and Retention) program sponsored by the UT System Office of Health and Academic Affairs, and Permanent Health Funds (PUF) requests. Budget requests are prioritized by the Dean to facilitate assurance that most essential objectives or initiatives are addressed. At the end of each fiscal year unallocated funds are used to support capital purchases and/or renovations. For the past two years renovations were for expansion of the scholarship office and classroom technology upgrades. Individual Department Chairs, Associate Deans and Directors may be queried for special items needed to support their areas. This end-of-year process supports the SON need to fund one-time initiatives. During FY , State funding resources were increased by $262,120 or 4.4% over FY 2012 budget allocations. This increase in state allocations allowed for modest faculty and staff merits, funding of promotions and other programmatic school-wide needs. The overall total amount of the SON Operating Funds budget has remained relatively stable due the entrepreneurial talents and strategic planning efforts to grow the Clinical Enterprise, research and training grants, service contracts and continuing education program opportunities. We anticipate the THECB Nursing Shortage Reduction funding to cease since enrollment and graduation numbers have leveled off. Therefore, the SON will rely on increased business opportunities through nursing continuing education and life-long learning opportunities, new high fidelity clinical simulation business partner opportunities, as well as continued partnerships such as those with the University, Veterans Administration, and Methodist Hospitals, which are used to offset faculty salaries (See Appendix II, Table II-A-2, University, VA and Methodist Hospitals System Dollars for Faculty Support). 19

26 Normally generated graduate level tuition funds are the major source of funding for the DNP program. The costs for transitioning to the DNP did not require new dollars. Instead, the focus was on re-allocating and re-focusing expenditures. As faculty retired, new faculty with the requisite knowledge skills and abilities were hired to implement the DNP program. The primary costs to the SON for the DNP program are faculty salaries. Additionally, in the fall semester the President s office authorized an additional 250k for new faculty recruitments. Our graduate faculty teach across programs, masters and doctoral. The SON strategically focused efforts on consolidating work across the school to eliminate staffing redundancy. Vacant staff positions were carefully evaluated before replacements were hired. Additional financial support, beyond the state appropriations for the SON, comes from a variety of sources as depicted in Table II-A-3, Comparison of SON Funding Sources for FY and Figure II-A-1, Distribution and Percentage of Funding Sources Forecast for FY Table II-A-3, Comparison of SON Funding Sources for FY to Forecast Funds for FY FY FY Forecast Variance % Change State (Original Allocation) $6,248,391 $6,248, PHF - includes fringe $1,384,000 $1,384, Coordinating Board Nursing Shortage Reduction Fund $399, $-399, % Methodist Health Ministries (MHM) CY $1,168,019 $1,168, Other Gifts and Pledges $936,000 $986, ,000 +5% Training and Research Grants $1,307,692 $1,225,192 $-82,500-6% Continuing Education Gross Revenue $189,780 $218,247 $+28, % UT Nursing Clinical Enterprise Gross Revenue $1,000,000 $1,200,000 $+200, % Endowment Earnings on Approx. 3.1 Million $122,822 $135, , % Student Fees $1,048,188 $1,060,000 $+11,912 +1% Discretionary and Faculty Funds $1,735,434 $1,577,667 $-157,767-9% TOTALS $15,540,283 $15,202,620 $-337,663-2% 20

27 Figure II-A-1 Distribution and Percentage of Funding Sources Forecast for FY 2014 All School of Nursing Operating Funds Forecast for FY 2014: $15,202,619 UT Nsg. Clin Ent, $1,200,000, 7.9% Endow on 3.1 mil, $135,104,.9% Student Fees, $1,060,000, 7% Continuing Education $218,247, 1.4% State, $6,248,391, 41% Discretionary, $1,577,667, 10.4% Res and Training Grants, $1,225,192, 8.1% Methodist HealthCare Ministries, $1,168,019, 7.7% Other Gifts, $986,000, 6.5% Permanent Health Funds, $1,384,000, 9.1% Monies are received via faculty grants and contracts. Gifts and endowments are primarily used for scholarships and endowed chairs or professorships. The School s Faculty Practice Plan established a set of accounts that will be self-supporting from revenues generated by faculty providing direct patient care. Compensation The Faculty Compensation Plan, drafted by the faculty, is defined in Chapter 4 of the Faculty Handbook, Section 4.9 (Resource Room, Standard II-A-2, Faculty Compensation Plan). The plan provides guidelines for faculty performance and identifies policies and processes to reward achievement of excellence above and beyond the expected faculty role through incentive compensation. The aptly named X, Y, Z plan is comprised of three components. X = Core Salary defined as the salary which is no less than the American Association of Colleges of Nursing (AACN) 70% of the median for each rank and educational preparation. Y = Specialty Associated Salary Augmentation based upon additional roles and responsibilities or specialty practice mutually agreed to by the faculty member and their Department Chair, and approved by the Dean. These additional roles may include clinical practice, education, research and scholarly activities performed in varied settings such as the community, health care, and professional organizations, or administrative assignments. The augmentation is reviewed and renewed annually, and ends when the special role ends. Z = Incentive Compensation and provides recognition for exemplary teaching, practice, research and/or service activities. Using 21

28 the AACN guidelines for comparison to the Faculty Compensation benchmark, (Table 17 and Table 33, AACN Salaries of Instructional and Administrative Nursing Faculty in Baccalaureate and Graduate Programs of Nursing, ) 100% of faculty salaries in the School of Nursing exceed 70% of the 50 th percentile (See Table II-A-4, Faculty Median Salaries: Trends Analyses for 12 month faculty for and Table II-A-4a, Faculty Median Salaries: Trends Analyses for 9 month faculty for ). Compensation of nursing unit personnel continues to support recruitment, and retention of qualified faculty and staff. Table II-A-4, Faculty Media Salaries: Trend Analyses for FY for 12-Month Faculty Salaries FY 11 FY 12 FY 13 AACN 50 th XYZ Comp. Actual % (Sept (Sept (Sept Benchmark* 70% of 50 th of 50 th 2010) 2011) 2012) Professor Doctoral $124,552 $126,338 $125,043 $133,855 $93, % Associate Professor- Doctoral $95,790 $97,706 $97,920 $101,464 $71, % Assistant Professor - Doctoral $80,000 $82,400 $82,400 $86,500 $60, % Assistant Professor- Non-Doctoral $71,810 $72,674 $71,810 $76,000 $53, % Instructor Non-Doctoral $70,000 $65,727 $65,076 $70,000 $49, % * Current Benchmark used: Table 33. AACN, Salaries of Instructional and Administrative Nursing Faculty in Baccalaureate and Graduate Programs in Nursing Table II-A-4a, Faculty Media Salaries: Trend Analyses for FY for 9-Month Faculty Salaries FY 11 FY 12 FY 13 AACN 50 th XYZ Comp. Actual % (Sept (Sept (Sept Benchmark* 70% of 50 th of 50 th 2010) 2011) 2012) Associate Professor- Doctoral $78,674 $81, $83,016 $58,111 n/a Associate Professor- Non-Doctoral $65,830 $66,730 $66,730 $67,613 $43, % Assistant Professor - Doctoral $65,957 $66,154 $66,154 $70,773 $49, % Assistant Professor- Non-Doctoral $59,447 $59,732 $59,022 $62,182 $43, % Instructor Non-Doctoral $53,244 $53,718 $54,001 $57,273 $39, % ** Current Benchmark used: Table 17. AACN, Salaries of Instructional and Administrative Nursing Faculty in Baccalaureate and Graduate Programs in Nursing We have made a concerted effort to increase the number of 12 month faculty and increase tenure track faculty in the Health Restoration and Care Systems Management and the 22

29 Family and Community Health Systems departments as depicted in Appendix II, Table II-A-5, Faculty Demographics by Department. Physical Resources Physical resources include the assigned space within the School of Nursing buildings, the original building built in 1974 and the other in 1997, and centrally managed classrooms. The Total Program Systematic Evaluation Plan incorporates a process that assures planned review of physical resources (Resource Room, Standard I-B-1, Total Program Systematic Evaluation Plan.) Review intervals are specified and data sources identified. Expected outcomes, action plans and results are similarly identified. The Dean has the authority to assess and reassign office and workspace based on the overall mission and needs of the SON. The President has ultimate authority of all the physical space. The 39-year old SON building has been strategically refreshed to meet education and research needs of faculty and students, focusing on simulation, classroom renovations and IT needs and the creation of new practice and scholarship spaces in line with SON strategic goals. Simulation: In June of 2012, the $3.9 million, 7,281-square-foot Center for Simulation Innovation (CSI) was unveiled. The simulated hospital features a wide variety of settings, including a trauma center, intensive care unit, maternal/child center, pediatric care suite, ambulatory care suite and home health setting. In the CSI nursing students and interprofessional teams of students and residents learn to appraise and respond to unique clinical scenarios and evaluate their responses. DNP students will have access to the CSI to develop, test, and pilot inquiry projects. Classrooms: Classrooms for the undergraduate and graduate programs are located within the School of Nursing and can accommodate 800 students. State regulations require specific parameters for faculty, staff and students use. There are adequate classrooms available in the SON for the DNP program. Classrooms are centrally managed by the University. If needed, additional classroom space can be scheduled in other areas across the campus. All of the classrooms are equipped with audiovisual equipment and computer Internet access. In addition, nine class /conference rooms can be used for student-faculty forums or round table discussions. During the holiday break 2012, classrooms were repainted. In January of 2013, plans for further upgrades to the classrooms were finalized. The upgrades will allow for presentations to be displayed in the room as well as audio conferencing via software applications such as Skype, Microsoft Lync, or Jabber. The upgrade will also allow 23

30 us to add a video component to the design at a later date. These modifications occurred in response to the needs of the DNP faculty to continue to guide and mentor students during times the students are not in the classroom. Appendix II, Table II-A-6, Classroom Upgrades, contains the equipment list and costs for classroom upgrades. Information Technology: Computers are supplied for all faculty and staff. There are an estimated 225 computers (desktop and laptops) throughout the School. Historically, the School has replaced approximately 30 computers annually. Given that the DNP courses are delivered, in part, via web enhanced technology, every effort is made to assure that faculty has up-to-date computer hardware and software. All of the faculty computers were refreshed in spring and summer 2010 using $120,000 in funds from the Methodist Healthcare Ministries Grant. Faculty were offered the option of having a desktop computer or laptop with a docking station as means to provide each faculty with the most effective computing support. Furthermore, each faculty computer was equipped with videoconferencing software and hardware. Student computer labs, originally located in the sublevel area of the new building, were moved to the first floor of the new building in summer The computer laboratory is available only to School of Nursing students. Each year, the student laboratory computers are evaluated for replacement. Computing services fees are used to support the purchase. The School provides medium speed and high speed copiers for use by faculty and staff. These copy machines and printers are available twenty-four hours per day seven days per week. Students have access to 64 computers and two shared printers located in rooms and The SON maintains a Service Level Agreement (SLA) with Information Management Systems (IMS) computer service providers for desktop and laptop computer and server support. (Resource Room, Standard II-A-7, Service Level Agreement). Part of this SLA provides a strategic analysis and assessment of capital equipment with a recommended amortization of all computers and printers. In addition, numerous computers and printers are available for students at the Briscoe library. Practice Spaces UT Nursing Clinical Enterprise: The office is located in suite of the main School of Nursing building. This section of the Vice Dean s suite has 3 offices and a reception area. A small conference room (for 6) is located adjacent to the office (2.108). The office provides the work space for the Vice Dean and UT Nursing Clinical Enterprise (UTNCE) staff. 24

31 Student Health Center: Since January 2007, the Student Health Center (SHC) has been located on the ground floor of the centrally located School of Nursing (SON) building. The SHC, designated as a non-smoking workplace, is approximately 2,200 square feet with growth from 2 to 7 NPs and 2 to 4 exam rooms (September 2009) equipped with standard exam tables and other equipment. The fourth exam room also serves as a private counseling area suitable for mental health promotion. In addition to the exam rooms, there is a waiting room that has seating capacity for 40 patients, intake and exit area, record storage area, small employee kitchen/meeting area, clinic manager s office, a shared APN provider s office, lab/immunization area, and an ADA equipped bathroom. The waiting area was recently renovated with new vinyl flooring and new chairs. The UTNCE is currently reviewing a renovation plan to further improve the patient and staff workflow. Employee Health and Wellness/Occupational Health Clinic: The Employee Health and Wellness Clinic (EHWC) is also part of the UT Nursing Clinical Enterprise, directed by Vice Dean, Dr. Julie Novak. There are approximately 6,000 UTHSCSA employees; approximately 50% of whom seek care at the clinic on a routine basis. The EHWC opened on November 15, 2010 and the patient volume continues to grow. The clinic is located in Bexar County, a designated medically underserved area (MUA); approximately 60% of the employee population is from underrepresented groups. The clinic is 1,500SF and has 3 exam rooms equipped with standard exam tables and equipment, electronic health records, a private counseling room suitable for mental health promotion, a phlebotomist lab, a shared APN provider office, and a patient waiting room that seats six with additional seating space in an adjacent hallway. The Student Health Center (SHC), located next door, allows additional space for mass screenings, vaccine/immunization programs, health fairs, and campus-wide health promotion/wellness projects. The EHWC provides the following services: primary care, occupational health, health promotion/disease prevention, immunizations, comprehensive health assessments, diagnosis and management of acute and chronic health problems, behavioral health counseling, smoking cessation and diabetes education. Services of a phlebotomist and onsite collection of laboratory specimens and CLIA waived in vitro laboratory diagnostic tests. Scholarship Spaces Office of Nursing Research and Scholarship: The space and staff are located in 2.392, is 823 sq. ft. and includes offices for 3 ONRS staff and a conference room for meetings, discussions and small class which fits 8-10 people. The space for funded studies is located in 2.390, is 823 sq. ft. The walls of the room are lined with paneled work stations. There are five 25

32 cubicles with computers and a central printing station. Each work station has locked and unlocked storage. Bookcases and filing cabinets line the outside walls of the work stations. A conference table which fits 6-8 people is also available in this room for meetings and discussions. Requests for space are reviewed and approved by the Committee on Scholarship and forwarded to the Dean and Associate Dean for Research. There is shared space is located in 2.404, is 1,282 sq. ft. and provides an environment fostering interdisciplinary/trans-disciplinary networking and scholarly exchange directed toward formation of collaborations and resulting in collaborative funded studies. This room fits people and has a large conference table with a white board with projection for meetings, presentations, and classes. Several computer-linked resources are available for faculty use in the Research Office. A computer with network-link and internet access is dedicated for faculty and doctoral students use. Programs available are Internet Explorer, Endnotes, Nudist, SPSS, and Microsoft Office. Computers are available by reservation with the ONRS. Computer programs can either be used directly by faculty or with the assistance of staff. The Biological Research Laboratory: This laboratory is a multi-use facility for faculty and student research involving physiological variables and measurements (862 square feet). Typically, DNP students do not use this space. A detailed description of the space can be found in the Resource Room, Standard II-A-8, Biological Research Laboratory. Centers of Excellence: The Center for Academic Evidence-Base Practice (ACE): The physical space that ACE occupies was renovated mid Eight modern, equipped workstations provide full computer equipment, software appropriate to the Improvement Science Research Network (ISRN) projects, access to 4 shared printers (including color), telephone, fax. The center includes an open meeting area and the ACE Library of specialty resources (such as IOM reports on crossing the quality chasm). ACE storage for research project files and materials includes a large bank of secure file cabinets and a storage area for the outreach and office materials necessary for the various projects. An immediately-adjacent workroom provides an additional duplication machine and fax. The ACESTAR website is housed within the SON website and contains a large number of publicly-accessible resources related to evidence-based practice. Two student workstations (desk, file cabinet) are available and have been used for international post-doctoral scholars. Both cable and wireless computer access are available at the workstations. The ACE portable laptop and ipad are available to the student workstations. The Center for Community-Based Health Promotion with Women and Children (CBHP) is housed within the Office of Nursing Research and Scholarship. The Center office, in room 26

33 2.402., provides individual workspaces (desks and chairs) for three staff members and one round table used for both faculty workspace and meetings. II-B. Academic support services are sufficient to ensure quality and are evaluated on a regular basis to meet program and student needs. Elaboration: Academic support services (e.g., library, technology, distance education support, research support, admission, and advising services)) are adequate for students and faculty to - meet program requirements and to achieve the mission, goals, and expected student and faculty outcomes. There is a defined process for regular review of the adequacy of the program s academic support services. Review of academic support services occurs and improvements are made as appropriate. Program Response University and School academic support services are available to support the SON programs, students, and faculty. They include Student Services, the Library, Information Management Services (IMS), the Office of Sponsored Programs, the Office of International Services, and the Clinical Learning Laboratory and Simulation Center at the SON and at the Howard E. Butt (HEB) Simulation Center in the Medical School. SON support services are more focused on achievement of SON mission, goals, and outcomes and include the Office of Admissions and Student Services, the Office of Academic Affairs, the Office of Research and Scholarship, and the Office of Practice/ Community Engagement each of which will be described in detail. Office of Student Services The Office Student Services includes the departments of Financial Aid, Counseling, Student Health Center, Registrar, and Student Life. The mission of The Office of Student Services is to provide services and programs to assist students in achieving their academic goals while helping to support and promote personal development and quality of life. Library Services The Health Science Center libraries, offers a full array of searchable databases including: PubMed, OvidSP (including Medline), CINAHL, Micromedex, MD Consult, SCOPUS, Stat!Ref Electronic Medical Library, UpToDate, and Web of Science with access to over 4,000 journal titles and articles. RefWorks is also available to students and faculty to manage references. The Library collection contains 221,886 book and journal volumes, over 92,000 print book titles, just under 9,000 electronic book titles, over 3,000 Print and Electronic serials (Health Sciences) and nearly 5,000 Print and Electronic serials (all subject areas). 27

34 The Libraries are staffed by 19.7 FTE librarians and 29.4 FTE library support staff. A librarian serves on each of the SON curriculum committees and attends the Faculty Assembly. Each Friday afternoon, a librarian provides remote librarian support for faculty and students in the SON. School of Nursing faculty and students have access to orientation sessions, consultations on databases, mediated searches, and Ask the Librarian resources. Instructional programs such as online teaching tutorials and demonstrations of MEDLINE and other health care databases are located in the University s virtual Knowledge Center and are posted on UTHSCSA homepage. DNP students use the Knowledge Center to update Microsoft Office skills and they attend classes given by Librarians on library searches and reference tools. Information Management Services (IMS) IMS within the Systems and Network Operations (SNO) provide instructional design, Bb Learn, Audiovisual/Classroom, and videoconferencing support resources for all schools. Their mission is to provide leadership in the use of communication technologies; to deliver a full array of communication services; and, to establish and maintain a voice, video, and computer network that provides cost effective and reliable service for the faculty, staff and students. Students comment that they particularly appreciate the technical troubleshooting and repair services provided by IMS that includes laptop and home desktop computers. Having this high level of support for students to mitigate technical issues enables them to focus on learning activities. Academic Technology Services (ATS), a division of IMS, provides consultation, technical assistance and creative expertise in support of the teaching/learning, research, health care and community engagement missions of the University. Three web specialist staff positions and two Educational Development Specialists were hired by ATS with funding from SON to support development of all new courses associated with curricula revisions. All faculty have been provided with the opportunity to achieve certification in online teaching and learning strategies. The web specialists are dedicated to reviewing and revising web pages and other services. In spring 2010 the ATS support staff reviewed and revised policies and processes for publishing course syllabi in the SON. Issues related to afterhours web support services emerged during the summer 2010 semester. At the beginning of the semester students and faculty experienced some difficulties accessing courses during non-business hours when no web support was available. IMS and the SON recognized the problem immediately, analyzed service needs, and instituted plans for more comprehensive coverage for the SON after hours. The SON now has access to afterhours help desk response system until 7:00 PM. In December 2010, Online Teaching and Learning Services began providing on call back up support for Bb Learn until 7:00 P.M. Extra 28

35 after hours support is also available during the first weeks of each new semester when student and faculty access problems are most likely to occur and affect timely achievement of goals and outcomes. Office of Sponsored Programs This office facilitates the achievement of faculty outcomes by providing ongoing support to faculty and staff who are submitting, managing, and completing grant-funded projects. The OSP reviews and approves all grants; establish and monitors grant funded accounts; and provides advice and support for all grants. Funds are managed by each school or grantee. Office of International Services This office serves as the liaison between faculty and staff and the Department of Homeland Security, Department of State, Department of Labor, and other national offices and organizations, by providing services to enhance and facilitate and promote safety for staff and students at the UTHSCSA. A primary focus of the Office of International Services (OIS) is to provide international education services, programs, and information to the HSC. Historically, the role of the OIS has been to provide immigration and visa services to the campus community and facilitate the stay of international personnel, including international students, at UTHSCSA. The OIS also functions as the designated administrative clearing-house and information source for all of the University s education abroad activities, including international agreement development and exchange program management. For example, in February 2009 a Mexico Travel Alert provided information about an increase in violence through Mexico and identified cities of greatest concern. During that time student and faculty from SON had planned a clinical elective course in Mexico, which had to be relocated to Guatemala. Center for Simulation Innovation (CSI) The SON provides a clinical learning laboratory for instruction in and practice of new competencies and inquiry project opportunities for the DNP program. This laboratory space was expanded to include a state-of-the-art simulation center. The laboratory is staffed by 5.6 FTE clinical nurse teaching associates who support teaching-learning activities. The current space includes a classroom and three demonstration units, each with eight beds and medium fidelity mannequins simulating patients across the lifespan. There are four examination rooms, one medication preparation area, and one room with a high fidelity Laerdahl adult simulator mannequin. The SON owns another Sim Man, four new third generation Sim Men, two Sim Babies and two Sim Newbies, a Noel pregnancy simulator, and a Harvey Cardio thoracic 29

36 simulator, as well as multiple low and medium fidelity human simulators, and task trainers. A variety of hospital rooms or units in the CSI are spaces where nursing students can safely practice and develop competencies and clinical decision making skills using the state-of- the-art hospital equipment and computerized simulation manikins. The center is equipped with control rooms, where faculty members observe and record student activities and program the manikins. The UTHSCSA also has a 24-exam room HEB simulation center located in the Administration building on the main campus. Between the facilities available at the SON and across campus, students and faculty have access to a full spectrum of simulation and technology supported teaching/learning opportunities to facilitate achievement of SON mission, goals, and student outcomes. The Office of Admissions and Student Services (OASS) Located in the SON, this office facilitates recruitment, application, admissions, and matriculation of nursing students at the undergraduate and graduate levels. Following an extensive evaluation of the services provided by this office in AY , a new Associate Dean for Admissions and Student Services was appointed, and significant reorganization of the office was instituted (Resource Room, Standard II-B-2, Reorganization Plan OASS). Subsequently, the OASS has, in collaboration with faculty and the Associate Dean for Academic Affairs, developed a SON recruitment plan (Resource Room, Standard II-B-3, SON Recruitment Plan). This office also provides information to prospective applicants; represents the school at recruitment/career events; provides pre-admission counseling, and conducts unofficial transcript evaluations for prospective applicants; provides public service /information services for local media when requested; supports the admissions process for all academic programs in concert with undergraduate and graduate committees; coordinates orientation for undergraduate and graduate programs, career plan development and ceremonial events such as commencement; supports student organizations; and provides other support services for enrolled students; administers the school s scholarship distributions; and is responsible for maintaining student service related records. The Student Services office is also responsible for facilitating access to other campus services for students, such as financial aid and counseling services in support of achievement of student outcomes and is staffed by a support person, and two academic coordinators/advisors. The Office for Academic Affairs (OAA) This office supports the school's educational goals of educating a diverse student body to become excellent nurses and nurse scientists. The office provides oversight of the development, implementation and evaluation of the curriculum to ensure the quality of education 30

37 offered. The office serves as a resource for faculty and students in both the undergraduate and graduate programs. Major responsibilities include: Strategic planning for academic programs Academic advisement and student progression issues Clinical site development and management of clinical contracts Coordination of accreditation and regulatory requirements Coordination of course schedules and maps Depository for student program plans, comprehensive exams, inquiry project and thesis/dissertation approvals and electronic inquiry projects. Development and coordination of academic policies and procedures Program evaluation oversight, including course and teaching evaluations SON Office of Nursing Research and Scholarship (ONRS) This office offers support services for research and scholarly activities of faculty and students. Available resources include assistance in: locating funding sources, preparing research proposals, literature searches, statistical analysis support, data management, research design, sampling design, instrument development, psychometric consultation, and manuscript and poster preparation and editing. A PhD prepared psychometrician, who is a tenure-track faculty member, also provides statistical consultation and expertise in research and sampling design. Since the initiation of the Dean s Award for Scholarly Pilot projects in 2009, the Associate Dean for Research in concert with the Committee on Scholarship have awarded monies to support 15 faculty projects (6 in 2009, 3 in 2010 and 6 in 2011). Each faculty received $5000 to support their pilot studies. Centers for Excellence The Centers for Excellence provide an opportunity for students to engage in scientific inquiry based on translational science, evidenced based practice, and population-based research. Center for Community-Based Health Promotion with Women and Children (CBHP): The SON houses the Anita Thigpen Perry Endowment for the Center for Community Based Health Promotion in Women and Children. The center is composed of a partnership between academia and community with the goal of developing health promotion projects. The goal of the Center is to collaborate with the community in the development, implementation, and evaluation of culturally proficient health interventions for Women and their families experiencing disparities in health outcomes. The Center Advisory Council is made up of 31

38 both interdisciplinary academic and community partners. Community partners include representatives of: Familias en Accion Community Collaborative Council (CCC), American Indians in Texas at the Spanish Colonial Missions (AIT-SCM), Mujeres Nobles de Harlandale, SUAVE (Southside United Against a Violent Environment), Coalition for GLBT Advocacy Group, and the Prosumer Group. Academic partners include faculty and staff from the School of Nursing, Department of Family and Community Medicine, Department of Surgery, School of Public Health, UTSA, and Texas Woman's University. Faculty in the Center are engaged in multiple projects which are available in the Resource Room, Standard II-B-1, CBHP Projects. Academic Center for Evidence-Based Practice (ACE): As a UTHSCSA center of excellence founded in 2000, ACE has continuously garnering extramural funding to conduct research in the field of evidence-based quality improvement and patient safety, workforce preparation, instrument development, and clinical consulting services supporting implementation of evidence-based practice improvements across disciplines. The ACE core team is comprised of three research scientists, two administrative event planners, a virtual communications specialist, and three research associates. Faculty scientists from across the disciplines of medicine, nursing, allied health, pharmacy, dentistry, and biomedical sciences are frequently part of the investigative teams on ACE projects. The ACE houses the $3 million Practice-Base Research Network for Improvement Science NIH grant. The Improvement Science Research Network (ISRN) was founded on UTHSCSA s long standing excellence in and commitment to clinical and translational research. The ISRN leverages existing infrastructure via the Institute for Integration of Medicine and Science (IIIMS) which houses our Clinical and Translational Science Award (CTSA), four longstanding primary care practice-based research networks (PBRNs), and our connection to the CTSA national consortium. In 2009 the ISRN began filling a national gap in improvement science by creating a central structure upon which to build a sustainable, comprehensive network for testing health care safety and improvement strategies across disciplines and in multiple, nationwide hospital settings. The ISRN is comprised of national members, an advisory Steering Council made up of national experts and a central Coordinating Center staff functioning as a virtual network within the Academic Center for Evidence-Based Practice (ACE). Two ISRN Network Studies are in progress: 32

39 1. Small Troubles, Adaptive Responses (STAR-2): Frontline Nurse Engagement in Quality Improvement (data collection complete; analysis near finalized; 14 sites engaged) 2. Impact of Cognitive Load, Interruptions, and Distractions on Procedural Failures and Medication Administration Errors (data collection launched January 2013; 10 sites engaged) Additional Network Studies is in progress (see ACE and ISRN activities are open to student engagement. In the past, a number of undergraduate, masters, and doctoral students have worked closely with ACE Team as part of their studies, garnering small grants and participating on ACE contracts. Currently, the ISRN Research Priorities for Improvement Science track closely with the DNP program competencies, targeting studies that advance quality and patient safety. DNP Students (all students) have membership in the ISRN that is fully subsidized. ISRN membership affords access to all ISRN resources, such as study modules and annotated bibliographies, recorded web seminars by national experts, and the ability to directly collaborate on the investigative teams of the ISRN Network Studies. The special Student Program of the annual Improvement Science Summit (a research methods conference) offers DNP students opportunities to attend the conference. During special sessions, students engage in small group roundtable discussions with world leading experts in the new field of improvement/implementation science. Future DNP student engagement includes a specialty blog with a DNP focus and highlights of DNP projects on the ISRN website. Office of Practice and Engagement (OPE) The Office of Practice and Engagement (OPE) was created in September 2009 with hiring the new Associate Dean for Practice and Engagement (re titled Vice Dean in March 2012). The goal of this office and the faculty committee for Practice/Community Engagement is to support achievement of the mission and goals associated with practice/community engagement initiatives. The practice initiatives for this Office have evolved into the UT Nursing Clinical Enterprise which creates or enhances practice settings where faculty and students integrate discovery, learning and engagement. The School has an active portfolio of practice and community engagement that is intended to assist faculty and students in achieving practice/community engagement scholarship objectives. This work is supported by a business administrator and marketing project coordinator. These individuals oversee contracts for faculty practice sites and engagement partnerships on and off campus. The Committee on Faculty Practice and Engagement provides guidance for the practice, consultation, and contractual institutional and community education activities of the SON in collaboration with the Vice Dean for Practice and Engagement and the Faculty Practice Plan Board. 33

40 Internally, the UT Nursing Clinical Enterprise includes the Student Health Center (SHC) run by the School of Nursing since FY In September 2009, the SHC expanded from 2 to 4 exam rooms and 2 to 7 faculty Advance Practice Nurses (APNs) to improve the system of care and to expand clinical sites and faculty practice opportunities. This clinic provides additional educational opportunities while creating an accessible, effective, safe, high quality nursemanaged system of care. The SHC is designated as a site serving medically underserved populations (SITE MUP) as defined in the Texas Department of State Health Services rules [25 TAC, Sec b)(2)]. The SHC team is supported by the collaborating physician, 3 faculty NPs, 1 full-time NP with faculty appointment, 1RN, 1 MA, Patient Services Rep, Business Administrator, Project, Marketing and Grants Coordinator, Quest phlebotomist and an Insurance clerk. The SHC team is a culturally diverse group including Spanish speakers. The services provided at the SHC include: primary care, health promotion/disease prevention, immunizations, comprehensive health assessments, diagnosis and management of acute and chronic health problems including behavioral health counseling, smoking cessation and diabetes; and onsite collection of laboratory specimens. The EHWC is located adjacent to the SHC. The EHWC staff is cross-trained and supports the SHC for TB Surveillance, flu and other vaccine/immunization programs, periods of high volume. The partnerships that have been developed culminated annual campus wide health fairs, fun run/walks, dedication of a campus walking trail, and the launch of monthly campus-wide and UT System-wide wellness, health promotion and disease prevention initiatives. II-C. The chief nurse administrator: Is a registered nurse (RN) Holds a graduate degree in nursing; Is academically and experientially qualified to accomplish the mission, goals, and expected student and faculty outcomes; Is vested with the administrative authority to accomplish the mission, goals, and expected student and faculty outcomes; and Provides effective leadership to the nursing unit in achieving its mission, goals, and expected student and faculty outcomes. Elaboration: The chief nurse administrator has budgetary, decision-making, and evaluation authority that is comparable to that of chief administrators of similar units in the institution. She consults, as appropriate, with faculty and other communities of interest, to make decisions to accomplish the mission, goals, and expected student and faculty outcomes. The chief nurse administrator is perceived by the communities of interest to be an effective leader of the nursing unit. The program provides a rationale if the chief nurses administrator does not hold a graduate degree in nursing. 34

41 Program Response The chief nursing administrator of the School of Nursing is Eileen T. Breslin, BSN, MS, PhD, RN, FAAN. The UTHSCSA Organizational Chart ( (Resource Room, Standard II-C-1, UTHSCSA Organizational Chart) depicts the Dean as the chief academic and administrative officer of the SON and indicates her relationship within the organizational structure as equivalent to the Deans of each of the other four schools in the UTHSCSA. For specific functions and duties of the Dean please see (UTHSCSA Handbook of Operating Procedures (HOP), Chapter 1 Administration and Organization, 2006). The Dean reports directly to the President as do the Deans from the other four schools and is vested with the administrative authority to accomplish the mission, goals and expected faculty and student outcomes of the SON. The Dean is academically and experientially qualified for her position. Dr. Breslin holds a BSN from Northern Arizona University, a MS in Maternal-Newborn Nursing from the University of Arizona, and a PhD in Nursing from the University of Colorado Health Science Center. She has served UTHSCSA as Professor and Dean of the School since April She has focused her academic career in higher education since 1983 including nine and a half years as Dean of the School of Nursing at the University of Massachusetts, Amherst (UMASS). While at UMASS she also served as Interim Dean of the School of Public Health & Health Sciences ( ). Her current professional service experiences include an appointment to the University Hospital Capitol Improvement Council and representing the AACN at the ANA Council of Practice and Economics. She is the AACN liaison to the DNP Task Force with the Veterans Administration and is the President-Elect of AACN. As described under other standards and key elements, the Dean can be credited with multiple new initiatives at the SON since her arrival. For example, both undergraduate and graduate curriculum revisions have been completed. The new CNL major was implemented in fall The DNP program was implemented in The new simulation center was built. Other improvements have been initiated in the physical plant and in academic and support services as described in Key Element II-B. Dean Breslin s accomplishments include initiating and strengthening partnerships with clinical agencies in the city and region and increasing SON research funding. Dean Breslin s curriculum vitae (CV) explicates a productive record of publication, presentations, and funded education and practice focused scholarly initiatives. Her discovery scholarship centers on violence, addiction, and women s health. She is a well-recognized nurse leader who is a Fellow in both the American Academy of Nurse Practitioners and the American Academy of Nursing. She has been recognized as a Distinguished Practitioner at the National Academies of Practice. Most recently Dean Breslin received the Presidential Award, the highest 35

42 award given by the National Hispanic Nurses Association Board of Directors, in recognition of her work supporting Hispanic nurses. In May 2010, the Delta Alpha Chapter of Sigma Theta Tau International and District 9 of Texas Nurses Association awarded the Dean the Imagemaker Award for Leadership (Resource Room, Standard II-C-2, Curriculum Vitae, Dean Breslin). II-D. Faculty members are: Sufficient in number to accomplish the mission, goals, and expected student and faculty outcomes; Academically prepared for the areas in which they teach; and Experientially prepared for the areas in which they teach. Elaboration: The full-time equivalency (FTE) of faculty involved in each program is clearly delineated, and the program provides to CCNE its formula for calculating FTEs. The mix of full-time and part-time faculty is appropriate to achieve the mission, goals and expected student and faculty outcomes. Faculty-to-student ratios ensure adequate supervision and evaluation and meet or exceed the requirements of regulatory agencies and professional nursing standards and guidelines. Faculty are academically prepared for the areas in which they teach. Academic preparation of faculty includes degree specialization, specialty coursework, or other preparation sufficient to address the major concepts included in courses they teach. Faculty teaching in the nursing program have a graduate degree. The program provides a rationale for use of any faculty who do not have a graduate degree. Faculty who are nurses hold current RN licensure. Faculty teaching in clinical/practicum courses are experienced in the clinical area of course and maintain clinical expertise. Clinical expertise may be maintained through clinical practice or other avenues. Faculty teaching in advanced practice clinical courses meet certification and practice requirements as specified by the relevant regulatory and specialty bodies. Advanced practice nursing tracks have lead faculty who are nationally certified in that specialty. Program Response Faculty members with full time appointments have a full time workload expectation for 40 hours per week of service to the school during the months of their contract. Texas Board of Regents Rules require a minimal assignment of 18 teaching workload credits to full time equivalent faculty as presented in Standard I Key Element C. Over the last three years, the percent of part time faculty has trended from 38% (43 of 114 faculty) in FY 2011, up to 45% (57 of total 128) in FY 2012, and back down to 42% (51 of 122) for FY2013. The Department Chairs appoint part time faculty and calculate part time FTE based on the number of days worked in a week, with one day considered a 20% FTE. For example, a faculty hired to teach two clinical groups per week for one semester, is allowed two days (40%) plus another day (total 60%) to complete other course related work such as participating in course meetings, holding office hours, developing lesson plans, and supporting exams or other course related projects. 36

43 All faculty who are nurses hold a Texas RN license and are academically prepared for the areas in which they teach. At this writing, the SON has 122 total faculty, of which 71 are fulltime faculty and 48 hold doctoral degrees. Forty-three faculty have 9 month appointments compared to 77 with 12 month appointments. Eighteen faculty are tenured, 14 faculty are on the tenure eligible track and 90 faculty are on the clinical track. The total faculty to student ratio is 1:6.75. Teaching productivity goals are tied to FTE and calculation of workload credits. Scholarly productivity is based on promotion and tenure expectations and is acknowledged in calculation of WLC. Ten (10) core faculty members teach in the DNP program. There are additional specialty and supporting faculty who are available to guest lecture, to work with students on inquiry projects and to mentor students enrolled in clinical application courses. The core and other UTHSCSA faculties who teach in the DNP Program are outlined in Appendix II, Table II-D-1, Core Faculty, Specialty Faculty, and Support Faculty. In addition, the School of Medicine (SOM), the School of Health Professions (SHP), and the UT Houston School of Public Health faculty are available to provide interprofessional opportunities, to facilitate learning and to serve on inquiry projects as needed. See Appendix II, Table II-D-2, Guest Faculty by Course. The Director of the DNP Program reports directly to the Associate Dean for Academic Affairs. The Director of the DNP Program works in close collaboration with Department Chairs and the Directors of the PhD and Master s Programs. Faculty expertise in the DNP program are broad and includes a mix of doctorally prepared research-focused and practice-focused faculty whose expertise supports the educational program required for the DNP. For example Dr. Kendall-Gallagher teaches the Healthcare Policy Analysis & Advocacy course (N7322) in the DNP program. In addition to her degrees in nursing, Dr. Kendall-Gallagher received her law degree in She served as a Legislative Drafter/Attorney Legislative Analyst/Attorney Advisor to the U.S. Department of Health & Human Services, Washington, DC, a Research Fellow for the Interdisciplinary Nursing Quality Initiative (INQRI) project at the University of Pennsylvania (in partnership with the Robert Wood Johnson Foundation) and most recently is certified by The Dartmouth Institute Microsystem Academy Coach. In addition to faculty members who are nurses, John Herbold, PhD, MPH, DVM, who is a faculty member in the UT Health Science Center at Houston School of Public Health, teaches the Fundamental of Epidemiology (NURS 6380). Several part-time nursing faculty provide special expertise and teach in specific courses. As demonstrated in the Curriculum Vitae (Resource Room, Standard II-D-1, Faculty Curriculum Vitae) the School of Nursing faculty members have strong teaching backgrounds, exceptional practice experience, mentoring experience, strong research and publication activity, active local, national, and international professional memberships, and are regularly requested as speakers and presenters at national and international professional 37

44 conferences and symposia. Many faculty serve in leadership capacities in their professional organizations, and with federal and non-federal agencies dedicated to solving societal and healthcare problems. II-E. When used by the program, preceptors, as an extension of faculty, are academically and experientially qualified for their role in assisting in the achievement of the mission, goals, and expected student outcomes. Elaboration: The roles of preceptors with respect to teaching, supervision, and student evaluation are clearly defined; congruent with the mission, goals, and expected student outcomes; and congruent with relevant professional nursing standards and guidelines. Preceptors have the expertise to support student achievement of expected learning outcomes. Preceptor performance expectations are clearly communicated to preceptors. Program Response Post-master s DNP students do not work with preceptors. They do, however, work with a clinical mentor/organizational partner, as approved by the student s advisor or faculty chair, who has expertise in the student s inquiry project area of interest. The clinical mentor/organizational partner facilitates the DNP student s access to clinical services, organizational information, decision makers, and other personnel in order to meet the DNP student s clinical application experience objectives and implement the inquiry project during the practicum within the organization. It is preferred that clinical mentor/organizational partner be doctorally-prepared (see Resource Room II-E-I, Curriculum Vitae for Organizational Mentors). II-F. The parent institution and program provide and support an environment that encourages faculty teaching, scholarship, service, and practice in keeping with the mission, goals, and expected faculty outcomes. Elaboration: Institutional support is available to promote faculty outcomes congruent with defined expectations of the faculty role and in support of the mission, goals, and expected student outcomes. For example: Faculty have opportunities for ongoing development in pedagogy. If research is an expected faculty outcome, the institution provides resources to support faculty research. If practice is an expected faculty outcome, opportunities are provided for faculty to maintained practice competence, and institutional support ensures that currency in clinical practice is maintained for faculty in roles which require it. If service is an expected faculty outcome, expected service is clearly defined and supported. Program Response Faculty members have opportunities for ongoing development in pedagogy, specialty practice, and development in the fields of the practice doctorate, research/scholarship, and service. The School supports faculty to attend conferences from local through international 38

45 venues. The Associate Dean for Academic Affairs has a $40,000 annual faculty development budget specifically earmarked for development in pedagogy. Faculty have been supported to attend the AACN Doctoral Education Conferences from and will be attending the AACN DNP Summit being held in April 2013 in Chicago. In light of the increased emphasis on quality improvement in the curricula, a group of faculty were supported to attend the QSEN competencies workshop offered by AACN. Graduate faculty have attended the AACN Master s Essentials conferences. Others have attended conferences intended to address education toward specific competencies addressed in educational essentials. Furthermore, as previously described in Key Element II-B, all SON faculty have had the opportunity to participate in online certification training. Most of those who teach using this technology have completed the certification course. In addition, nursing faculty regularly attend the National Organization of Nurse Practitioner Faculties and the International Society for Psychiatric Nursing conferences as well as others. Development opportunities related to practice are supported by the departments. Faculty also participate in multiple research focused conferences. The SON is part of Southern Nursing Research Society as well the Western Institute of Nursing. Funding for these conferences may come from grants, endowed professorships, departments, or other sources. Table II-F-1, depicts Support for Faculty Conference Attendance. Table II-F-1 Support for Faculty Conference Attendance by Academic Affairs Travel/Development # Supported Amount of Support $ $ $ Consultants who have expertise in curriculum development, DNP program implementation, and mentoring have conducted all-school faculty retreats. The following consultants, listed in Table II-F-2, Consultants, have advised the faculty in areas related to curriculum development in the Graduate Nursing Program: 39

46 Table II-F-2, Consultants Date Focus Consultant June 2007 State of the Science in Health Care Informatics Education Judith Warren, PhD, RN, FAAN, FACME Kansas University Medical Center Kansas City, KS December 2007 December 2008 August 2008 August 2008 February 2010 Curriculum Development, Information Technology, and the Healthcare Environment CNS Practice & Education: Moving Curriculum to the DNP Regulatory Models for Advanced Practice Nurse Nursing Education Implications Doctor of Nursing Practice, Implications for Nursing Education Nursing Informatics for Quality, Safety and Nursing Practice Diane Skiba, PhD, FAAN, FACMI University of Colorado at Denver & Health Science Center Denver, CO Mary Lou Sole, PhD, RN, CNS, CCRN, FAAN, University of Central Florida College of Nursing Orlando, FL Joan Stanley, RN, CRNP, FAAN Senior Director of Education Policy American Association of Colleges of Nursing Carol Picard, PhD, RN, Professor University of Massachusetts Amherst Amherst, MA Rita Snyder, PhD, RN Visiting Professor July 2011 DNP Site Visit Consultants Linda Lindeke, PhD, RN, CNP Director of Graduate Studies University of Minnesota Patricia Morton, PhD, RN, CRNP, FAAN Associate Dean for Academic Affairs University of Maryland November 2011 March 2012 July 2012 Nurse Practitioner Curriculum; Recommendations regarding new Master s Essentials while providing transition into DNP program Revision of Acute Care Nurse Practitioner (ACNP) major to new Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) track Nurse Practitioner Curriculum; Review of progress on previous recommendations regarding new Master s Essentials while providing transition into DNP program Patricia Ryan Lewis, PhD, RN Associate Dean for Nursing Clinical Practice Studies University of Illinois at Chicago, Rockford Regional Program Dr. Margaret McAllister, PhD, RN, FNP-BC, FAANP Associate Professor & Co-Director of DNP Expert in Curriculum Development University of Massachusetts Ruth Kleinpell, PhD, RN, FAAN, FCCM Director, Center for Clinical Research and Scholarship Professor, Rush University School of Nursing Dr. Margaret McAllister Associate Professor & Co-Director of DNP Expert in Curriculum Development University of Massachusetts On October 29, 2010 the office of Continuing Nursing Education provided a day long faculty workshop on outcomes from the Carnegie study on Educating Nurses with Dr. Molly Sutphen and Dr. Lisa Day as speakers. The School s research seminars also provide opportunities for on-site professional development as one means to fulfill the goals of providing 40

47 opportunities for faculty and staff to engage in the research, education, and service missions of the University. Strengths The growing clinical enterprise, with the student health clinic MUP designation, signifies congruence with mission and goals related to providing care, strong support for faculty development in the scholarship of practice, and growth of clinical opportunities for students to enhance achievement of learning outcomes. The SON has actively evaluated space and physical resource needs of the school and has been able, with the support of the COI and other sources, to renovate spaces and improve infrastructure in support of achievement of programmatic goals. The SON has exhibited outstanding fiscal responsibility and maintained program quality through provision of resources that facilitate achievement of mission, goals and student outcomes. Information Management Systems has been singled out by students and faculty in regard to their contribution to enhancing technology supported learning. Both IMS and ATS are active participants in all academic endeavors and have contributed to faculty development, incorporation of technology, and to creating a transformative teaching - learning environment for students. Clinical mentors/organizational partners in the community have also provided a significant level of support also adding to the learning environment. The clinical liaison and strong relationships with community clinical partners has allowed the SON to grow enrollments. Opportunities for Improvement While the SON has maintained program quality, turbulent economic times require generation of revenue apart from State funding through streams such as grants, contracts, and service revenues. Action: Efforts have been instituted to put the SON into a better revenue generating position with the Office of Practice and Engagement. This is a new initiative and the SON will continue, through strategic planning, to monitor, support, and evaluate effectiveness and efficiencies of new clinical enterprises. Action: Recruitment of funded senior researchers. This is an ongoing challenge. Action: More emphasis on state supported recruitment programs such as Enrich Nursing Through Exceptional Recruitment (ENTER) and STARS will be explored and used to maximize recruitment and retention efforts. ENTER is a recruitment program sponsored by the University of Texas System Office of Health and Academic Affairs. The STARS program 41

48 ( is a University of Texas system office program to focus on high caliber senior faculty where the required resources are above and beyond the amount that would be available through routine institutional funding. 42

49 Standard III Program Quality: Curriculum and Teaching-Learning Practices The curriculum is developed in accordance with the mission, goals, and expected aggregate student outcomes and reflects professional nursing standards and guidelines and the needs and expectations of the community of interest. Teaching-learning practices are congruent with expected individual student learning outcomes and expected aggregate student outcomes. The environment for teaching-learning fosters achievement of expected individual student learning outcomes. III-A. The curriculum is developed, implemented, and revised to reflect clear statements of expected individual student learning outcomes that are congruent with the program s mission, goals, and expected aggregate student outcomes. Elaboration: Curricular objectives (course, unit, and/or level objectives or competencies as identified by the program) provide clear statements of expected individual student learning outcomes. Expected individual student learning outcomes contribute to achievement of the mission, goals, and expected aggregate student outcomes. Program Response The route of entry to the Doctor of Nursing Practice (DNP) program is the post-masters in nursing (MSN). The DNP program is for students who already hold a master's degree in nursing and who have a nursing preparation at the graduate level from a nationally accredited school of nursing. The DNP program takes into account previous academic coursework and clinical experiences. The UTHSCSA SON DNP program is designed to prepare nursing leaders for the highest level of professional nursing practice beyond the initial preparation in the discipline in one of three program tracks: 1) Nurse Practitioner Leadership, 2) Executive Administrative Management, or 3) Public Health Nurse Leader. Specifically, the UTHSCSA SON DNP program is designed to: 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. Prepare graduates to partner in improving health outcomes of the community through the interprofessional collaboration and consultation with health care professional teams. 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 patientcentered care. The nursing faculty has developed a curricular framework which forms the basis for the program, individual, and aggregate student learning outcomes. This framework represents a systematic organization of concepts that are viewed as the essential components of the SON DNP curriculum. The framework serves as a guide and provides direction for faculty to organize 43

50 nursing knowledge into nursing courses, advanced nursing clinical practice, and scholarly inquiry. The curriculum is based upon the eight core concepts (Figure III-A-1 SON DNP Curricular Model) and eight program outcomes (Table III-A-1 Comparison of SON DNP Curricular Concepts with SON DNP Program Outcomes) Figure III-A-1 SON DNP Curricular Model 44

51 TABLE III-A-1 Comparison of SON DNP Curricular Concepts with SON DNP Program Outcomes SON DNP Curricular Concepts Scientific Foundation Quality Practice Inquiry Technology & Information Literacy Policy and Ethics Leadership Practice Inquiry Health Care Delivery System SON DNP Program Outcomes 1. Integrate nursing science, ethics, biophysical, 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 interprofessional 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 advanced 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 SON DNP curriculum was developed in accordance with the mission, values and goals of the SON and the UTHSCSA, and is consistent with relevant professional nursing standards and guidelines. The fourth goal under strategy #2 in the SON education strategic plan is to design, implement, and evaluate innovative curricula aligned with professional accreditation and regulatory requirements to meet current and future workforce demands. To achieve this goal, the expected student learning outcomes for the SON DNP program were crafted based on the Essentials of Doctoral Education for Advanced Nursing Practice developed by the American Association Colleges of Nursing (AACN, 2006), the National Organization of Nurse Practitioner Faculties (NONPF) Core Competencies for Nurse Practitioners (NONPF, 45

52 2012), Criteria for Evaluation of Nurse Practitioner Programs (NTF, 2012), The American Organization of Nurse Executives (AONE) Nurse Executive Competencies (AONE, 2011), and the American Nurses Association (ANA) Public Health Nursing Scope and Standards for Advanced Practice Nursing (Quad Council, 2012) which are tied to the SON DNP program outcomes. The relationship of the SON DNP program outcomes and the AACN Essentials of Doctoral Education for Advanced Nursing Practice is depicted in Table III-A-2 Comparison of SON DNP Program Outcomes with AACN Essentials of Doctoral Education for Advanced Nursing Practice. TABLE III-A-2 Comparison of SON DNP Program Outcomes with AACN Essentials of Doctoral Education for Advanced Nursing Practice SON DNP Program Outcomes 1. Integrate nursing science, ethics, biophysical, 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 interprofessional 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 advanced 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. Essentials of Doctoral Education for Advanced Nursing Practice Essential I: Scientific Underpinnings for Practice Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking Essential III: Clinical Scholarship and Analytical Methods for Evidence-Based Practice Essential IV: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care Essential V: Health Care Policy for Advocacy in Health Care Essential VI: Interprofessional Collaboration for Improving Patient and Population Health Outcomes Essential VII: Clinical Prevention and Population Health for Improving the Nation s Health Essential VIII: Advanced Nursing Practice The SON DNP program is designed to prepare 1) an APRN for specialization in direct patient care in a specific population within the broader context of reviewing the best evidence for care and implementing collaborative delivery systems and 2) for nurses with a specialized focus 46

53 in health policy, informatics, or population-based care who engage in practice at the aggregate systems or organizational level (AACN, 2006). As such, the SON DNP program provides scientific inquiry based on translational science and evidenced-based practice, populationbased research and advanced specialty clinical practice, core leadership courses in public policy advocacy, improving organizational effectiveness, health informatics, and financial and business management. In the SON DNP program, course outcomes provide a structure signifying systematic progression through the program, to attain aggregate student outcomes. Each course outcome is tied to the program outcomes (Appendix III, Table III-A-3 Statements of Expected DNP Individual Learning Outcomes Related to SON DNP Program Outcomes). These individual student learning outcomes contribute to achievement of overall expected aggregate student outcomes. DNP program outcomes are expected to be met by students upon completion of the program of study. Individual student learning outcomes are communicated to ongoing students through course syllabi (Resource Room, III-A-1, Course Syllabi). Course content and course expectations reflect course outcomes (i.e. expected individual student learning outcomes). Course sequence in the DNP program builds from essential content, knowledge, and skills. The Essentials concepts are addressed in content and learning activities within both course and clinical practice based on expected individual learning outcomes. There is a discernible sequential pattern of individual learning expectations spelled out through courses that culminate in program outcomes. III-B. Expected individual student learning outcomes are consistent with the roles for which the program is preparing its graduates. Curricula are developed, implemented, and revised to reflect relevant professional nursing standards and guidelines, which are clearly evident within the curriculum, expected individual student learning outcomes, and expected aggregate student outcomes. Baccalaureate program curricula incorporate The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008). Master s program curricula incorporate professional standards and guidelines as appropriate. a. All master s programs incorporate the Graduate Core Curriculum of The Essentials of Master s Education for Advanced Practice Nursing (AACN, 1996) and additional relevant professional standards and guidelines as identified by the program. b. All master s-level advanced practice nursing programs incorporate the Advanced Practice Nursing Core Curriculum of The Essentials of Master s Education for Advanced Practice Nursing (AACN, 1996). In addition, nurse practitioner programs incorporate Criteria for Evaluation of Nurse Practitioner Programs (NTF, 2008). Graduate-entry program curricula incorporate The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008) and appropriate graduate program standards and guidelines. 47

54 DNP program curricula incorporate professional standards and guidelines as appropriate. a. All DNP programs incorporate The Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006) and incorporate additional relevant professional standards and guidelines as identified by the program. b. All DNP programs that prepare nurse practitioners also incorporate Criteria for Evaluation of Nurse Practitioner Programs (NTF, 2008). Elaboration: Each degree program and specialty area incorporates professional nursing standards and guidelines relevant to that program/area. The program clearly demonstrates where and how content, knowledge, and skills required by identified sets of standards are incorporated into the curriculum. Advanced practice master s programs (Clinical Nurse Specialist, Nurse Anesthesia, Nurse Midwife, and Nurse Practitioner) and DNP programs with a direct care focus incorporate separate graduate level courses in health/physical assessment, physiology/pathophysiology, and pharmacology. Additional content in these areas may be integrated as needed into specialty courses. Separate courses in physical assessment, physiology/pathophysiology, and pharmacology are not required by CCNE for students enrolled in post-master s DNP programs who hold current national certification as advanced practice nurses, unless the program has deemed this necessary. Program Response The students can obtain a DNP degree in one of three program tracks: 1) Nurse Practitioner Leadership, 2) Executive Administrative Management, or 3) Public Health Nurse Leader. Currently, there are 15 students (1 on LOA) in the Nurse Practitioner Leadership track and 8 students (1 on LOA) in Executive Administrative Management track. Plans are to admit six (6) students to the Public Health Nurse Leader track in the spring of 2013 to begin coursework in the fall of Nurse Practitioner Leadership The Nurse Practitioner Leadership track is for nurses who are nationally certified nurse practitioners and hold Advanced Practice Nurse (APN) licensure. The SON DNP Nurse Practitioner Leadership consists of a total 41 credits and can be earned in 5 semesters as a full time student and in 7 semesters as a part time student (see Appendix III, Table III-B-1 and III-B- 2 Nurse Practitioner Leadership Full-Time and Part-Time Program Plans). The Nurse Practitioner leader employs advanced levels of clinical judgment, systems thinking, and accountability to design, deliver, and evaluate evidence-based, culturally proficient care to improve patient and population outcomes. The Nurse Practitioner Leadership graduates have knowledge, skills, and abilities (KSA) that are important to clinical practice. This KSA include refined communication; scientific foundations; experience with emphasis on independent and interprofessional collaborative practice; analytic skills for evaluating and providing evidence-based patient care within and across settings; and advanced knowledge of the health care delivery system and healthcare policies. Areas of increased KSA include leadership, policy and the business of health care. 48

55 The AACN Essentials of Doctoral Education for Advanced Nursing Practice (2006) are the foundation outcome competencies deemed essential for graduates of a DNP program regardless of specialty or population focus. The Nurse Practitioner Leadership DNP competencies are based on the recommendations of the National Organization of Nurse Practitioner Faculties (NONPF, 2012) to address DNP core competencies beyond the population-focused competencies at their master's level (Table III B-1 Comparison of SON DNP Program Outcomes and NONPF Competencies). These competencies were taken into consideration when designing the DNP program. TABLE III B-1 Comparison of SON DNP Program Outcomes and NONPF Competencies * SON DNP Program Outcomes NONPF Competencies 1. Integrate nursing science, ethics, biophysical, psychosocial, 1. Scientific Foundation Competencies (2) 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 interprofessional 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 advanced 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. 1. Scientific Foundation Competencies (4) 2. Quality Competencies (2, 3) 1. Scientific Foundation Competencies (1,3) 2. Quality Competencies (1,5) 3. Independent Practice Competencies (1,2,3) 4. Practice Inquiry Competencies (2,3,6) 1. Technology and Information Literacy Competencies (1,2,3,4,5) 2. Ethics Competencies (3) 1. Policy Competencies (1,2,3,4,5,6) 2. Ethics Competencies (1) 3. Leadership Competencies (4,7) 1. Leadership Competencies (1,2,3) 2. Quality Competencies (4) 3. Health Delivery System Competencies (7) 1. Ethics Competencies (2) 2. Leadership Competencies (5,6) 3. Practice Inquiry Competencies (1,4,5) 1. Independent Practice Competencies (4) 2. Health Delivery System Competencies (1,2,3,4,5,6) * see Resource Room, Standard III-B-1 for complete listing of NONPF Competencies Executive Administrative Management The Executive Administrative Management track is for students with a master s degree in nursing in administrative management or a master s degree in nursing with equivalent experience in a healthcare leadership position who seek preparation as an executive level nurse leader. The SON DNP Executive Administrative Management consists of 48 credit hours and can be earned in 6 semesters as a full time student and 8 semesters as a part time student (see 49

56 Appendix III-B-3 and III-B-4, Executive Administrative Management Full-Time and Part-Time Program Plans). The Executive Administrative Management leader is a nurse prepared through graduate education to lead and manage nursing care in health care systems across the continuum of care. This nurse professional provides strategic direction for all aspects of nursing care and care delivery operations for multiple clinical departments, hospitals and clinical agencies; establishes standards for the management of the business of nursing practice through financial management, human resource management, performance improvement, critical thinking skills, use of technology, strategic management, and clinical practice knowledge. The Executive Administrative Management graduate leads nursing practice at the highest levels of health care organizations. The Executive Administrative Management leader advocates for nursing through relationship building, interprofessional collaboration, and system governance; facilitates promotion of cultural proficiency, social justice, and shared decision making; and assures the constant organizational focus and achievement of quality safe patient care. The Executive Administrative Management leader advocates for the profession, leads health care policy formulation and implementation, and role models a commitment to learning and development through personal and professional accountability for his/her executive leadership and management practice. Standards for nursing administrative graduate programs are established by the specialty organization, The American Organization of Nurse Executives (AONE) and form the basis for the Executive Administrative Management track (Table III B-2 Comparison of SON DNP Program Outcomes and AONE Competencies). Graduates are eligible for certification as Certified in Executive Nursing Practice for the credential, CENP; and from the American Nurses Credentialing Center as a Nurse Executive, Advanced for the credential, NEA-BC. TABLE III B-2 Comparison of SON DNP Program Outcomes and AONE Competencies * SON DNP Program Outcomes AONE Competencies 1. Integrate nursing science, ethics, biophysical, 1. Leadership skills (a, e) 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. 2. Use analytic methods and evidence based practices to improve practice outcomes and the practice environment. 3. Implement and evaluate ethical healthcare information systems and patient care technology to improve the quality of patient health outcomes and care systems. 1. Knowledge of the health care environment (b,g, j) 1. Professionalism (d) 2. Knowledge of the health care environment (f) 1. Business skills (e) 2. Knowledge of the health care environment (f, h, i) 50

57 TABLE III B-2 Comparison of SON DNP Program Outcomes and AONE Competencies * SON DNP Program Outcomes 4. Advocate for healthcare practices that advance social justice, equity, and ethical policies within all healthcare arenas. 5. Employ interprofessional collaborative teams to improve patient and population health outcomes and healthcare delivery systems. 6. Lead the integration and institutionalization of evidence based clinical prevention and population based health guidelines. 7. Use advanced 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. AONE Competencies 1. Communication and relationshipbuilding (d, f) 2. Knowledge of the health care environment (d) 3. Professionalism (c) 1. Communication and relationshipbuilding (a, b, c, e, h) 2. Knowledge of the health care environment (e) 3. Professionalism (f) 1. Communication and relationshipbuilding (g) 2. Professionalism (a, b) 3. Leadership skills (b, d) 4. Business skills (a, b, d) 5. Knowledge of the health care environment (c) 1. Professionalism (e) 2. Leadership skills (c) 3. Business skills (c) 4. Knowledge of the health care environment (a) * see Resource Room, Standard III-B-2 for complete listing of AONE Competencies Public Health Nurse Leader The Public Health Nurse Leader track is for students with a master s degree in nursing who desire leadership preparation in population-based public health nursing. Nurses in this track receive a Public Health Certificate from the University of Texas Houston School of Public Health concurrent with the SON DNP degree (see Resource Room, III-B-3, MOU UTHSCSA and UTSPH). The SON DNP Public Health Nurse Leader consists of 51 credit hours and can be earned in 7 semesters as a full time student and 9 semesters as a part time student (see Appendix III-B-5 and III-B-6, Full-Time and Part-Time Public Health Nurse Leader Program Plans). The DNP Public Health Nurse Leader is prepared to lead public health systems delivery of essential public health services to improve population health. Through a combination of nursing and public health education, the Public Health Nurse Leader designs innovations in population-based health care, administers public health care systems, and designs evidence based services for populations across the lifespan. In 2011, the Quad Council of Public Health Nursing Organizations (QCPHNO) updated its Core Competencies for Public Health Nurses (CCPHN) to align with the Council on Linkages Between Academia and Public Health Practice s revised Core Competencies for Public Health Professionals (CCPHP). The CCPHN are based 51

58 on the same eight domains and three-tier structure as the CCPHP. Therefore, competencies incorporated into this track are based on the QCPHNO (2011) Tier 3 as shown in Table III B-3. These competencies apply to public health nurses at an executive management and leadership level. Students are prepared for certification as a Public Health Administrator. Table III B-3 Comparison of SON DNP Program Outcomes and Quad Council of Public Health Nursing Organizations Core Competencies for Public Health (2011) Tier 3 * SON DNP Program Outcomes 1. Integrate nursing science, ethics, biophysical, 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 interprofessional 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 advanced 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. Tier 3 Public Health Nursing Core Competencies Domain 1: Analytic and Assessment Skills (1,2,3) Domain 5: Community Dimensions of Practice Skills (2) Domain 6: Public Health Sciences Skills (3) Domain 7: Financial Management and Planning Skills (1,5) Domain 8: Leadership and Systems Thinking Skills (1) Domain 2: Policy Development/Program Planning Skills (6) Domain 4: Cultural Competency Skills (2) Domain 6: Policy Development/Program Planning Skills (3) Domain 7: Financial Management and Planning Skills (1) Domain 1: Analytic and Assessment Skills (9, 12) Domain 5: Community Dimensions of Practice Skills (6, 10) Domain 3: Communication Skills (6) Domain 7: Financial Management and Planning Skills (3) Domain 8: Leadership and Systems Thinking Skills (6) Domain 2: Policy Development/Program Planning Skills (10) Domain 7: Financial Management and Planning Skills (3) Domain 4: Cultural Competency Skills (7) Domain 8: Leadership and Systems Thinking Skills (1) * see Resource Room, Standard III-B-4 for complete listing of Quad Council PH Competencies The DNP Program incorporates The Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006). Using The Essentials, members SON DNP Program Committee reviewed the SON DNP courses to determine fit. The work involves cross walking The Essentials with the course description, course objectives, teaching learning strategies, and individual student learning outcomes (see Appendix III, Table III-B-7, Congruency among The Essentials of Doctoral Education for Advanced Nursing Practice and Courses in the SON DNP Nurse Practitioner Leadership Track; Appendix III, Table III-B-8, Congruency among The Essentials of Doctoral Education for Advanced Nursing Practice and Courses in the SON Executive Administrative Management Track; Appendix III, Table III-B-9, 52

59 Congruency among The Essentials of Doctoral Education for Advanced Nursing Practice and Courses in the SON DNP Public Health Nurse Leader Track. III-C. The curriculum is logically structured to achieve expected individual and aggregate student outcomes. The baccalaureate curriculum builds upon a foundation of the arts, sciences, and humanities. Master s curricula build on a foundation comparable to baccalaureate level nursing knowledge. DNP curricula build on a baccalaureate and/or master s foundation, depending on the level of entry of the student. Elaboration: Baccalaureate program faculty and students articulate how knowledge from courses in the arts, sciences, and humanities is incorporated into nursing practice. Postbaccalaureate entry programs in nursing incorporate the generalist knowledge common to baccalaureate nursing education as delineated in The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008) as well as advanced course work. Graduate curricula are clearly based on a foundation comparable to a baccalaureate degree in nursing. Graduate programs delineate how students who do not have a baccalaureate degree in nursing acquire the knowledge and competencies comparable to baccalaureate education in nursing as a foundation for advanced nursing education. Accelerated programs that move students from basic nursing preparation (e.g., associate degree or diploma education) to a graduate degree demonstrate how these students acquire baccalaureate level knowledge and competencies delineated in The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008), even if they do not award a baccalaureate degree in nursing in addition to the graduate degree. DNP programs, whether post-baccalaureate or post-master s, demonstrate how students acquire doctoral-level competencies delineated in The Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006). The program provides a rationale for the sequence of the curriculum for each program. Program Response The DNP curriculum builds on a master s foundation and on generalist knowledge as well as advanced graduate level coursework (Table III-C-1 Comparison of SON MSN and SON DNP Program Outcomes). The curriculum has a scientific underpinning as well as sequenced coursework that provides for an opportunity to gain the knowledge and skill of advanced nursing specialty practice in either direct or indirect patient care. 53

60 Table III-C-1 Comparison of SON MSN and SON DNP Program Outcomes SON MSN PROGRAM OUTCOMES 1. Integrate scientific findings from nursing and related sciences into the delivery of advanced nursing care to populations in diverse settings. 2. Assume organizational and systems leadership to assure ethical and critical decision-making at all systems; levels for quality and patient safety. 3. Lead performance improvement technologies for quality, safety, and patient-centered care delivery. 4. Use translational scholarship and processes to achieve optimal patient care and care environment outcomes. 5. Integrate meaningful information systems and healthcare technologies to support and improve safe, quality patient care. 6. Promulgate policy and effect change through advocacy that influences health care at appropriate levels. 7. Lead interprofessional teams using collaborative strategies to effect quality patient care and population health outcomes. 8. Synthesize broad ecological and social health determinants to design and deliver evidencebased clinical prevention and population health care and services to individuals, families, and aggregates/identified populations. SON DNP PROGRAM OUTCOMES 1. Integrate nursing science, ethics, biophysical, 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 interprofessional 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 advanced 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. III-D. Teaching-learning practices and environments support the achievement of expected individual student learning outcomes and aggregate student outcomes. Elaboration: Teaching-learning practices and environments (classroom, clinical, laboratory, simulation, and distance education) support achievement of expected individual student learning outcomes identified in course, unit, and/or level objectives. Program Response A variety of traditional and innovative teaching-learning practices appropriate for the adult learner offer SON DNP students numerous opportunities to achieve expected learning outcomes. The SON DNP program is delivered in a face-to-face format enhanced by course management system technologies. Students are required to be on the main San Antonio campus for 55% or more of the program hours. For clinical application hours, students are 54

61 assigned to practice sites managed by organizational mentors and monitored by faculty and/or faculty chairs. All courses in this program are web-supported using course management systems technology. However the use of technology is supplemental to face to face instructions. The institution utilizes the Bb Learn Course Management System for all academic courses offered at the institution. Bb Learn provides students with course-specific information and is a means of communication between the students and course faculty. Bb Learn is also utilized for access to course objectives, class topics and learning outcomes, reading and other class assignments, announcements, discussions, assignment submission and lecture and seminar materials. is used to maintain communication among students, faculty, and staff. All students and faculty are provided with a valid university account. Faculty will keep online and/or phone office hours as well as posted office hours to meet student needs. Participating faculty members are certified in Online Teaching and Learning UTHSCSA Academic Technology Services Department Faculty. Hence faculty are well prepared to use Bb Learn and create learning activities in an on-line format to meet program outcomes. Additionally, the SON supports a position of Educational Development Specialist, responsible for faculty consultation during course creation and development. Program Content The DNP program content incorporates venues such as seminars, lectures, and clinical experiences. All didactic courses are taught face to face, incorporating the use of technology where necessary; primarily using the Bb Learn course management system. For clinical experiences, the teachings are done in actual clinical practice settings face to face by preceptors, organizational mentors and evaluated by faculty. Practice Experiences The SON DNP program provides rich and varied opportunities for practice experiences aimed at helping graduates achieve integration of the DNP competencies. Practice experiences are designed to enhance and expand student competencies for articulating and enacting the tripartite role (practice inquiry, advanced nursing clinical practice, and interprofessional leadership) in a practice setting that is relevant to the student's advanced practice nursing specialty and program plan. Specifically, the purposes of the practice experiences are: to synthesize and expand knowledge about advanced specialty practice that integrates evidence and leadership; to broaden the student's clinical set at the doctoral level regardless of role or experience; 55

62 to support the inquiry project to translate scientific evidence into practice to improve patient outcomes of care; to provide students the opportunity to analyze leadership principles to promote communication and collaboration; to evaluate key issues that affect the advanced practice registered nurses' ability to influence practice, health systems, and policy. to provide evidence of achievement of end-of-program competencies In order to achieve the DNP competencies, the program provides the additional practicum hours needed to meet the post-baccalaureate minimum of 1,000 hours of practice as part of a supervised academic program. There are a minimum number of clinical/practicum hours required for each track in the DNP Program. The Nurse Practitioner Leadership and Public Health Nurse Leader tracks require a minimum of 360 clinical hours, and the Executive Administrative Management track requires 540 clinical hours. Therefore, Nurse Practitioners and Public Health Nurse Leaders must have completed 640 clinical hours in their previous graduate program(s) and Administrative Managers 460 clinical hours to meet AACN's requirement. Students who do not meet these criteria will be evaluated and may be required to take a clinical application course designed to provide the additional hours needed to complete the required 1,000 clinical hours for the DNP degree. The SON provides an academic environment that offers substantial access to practice expertise (direct and indirect care) and opportunities for students to work with and learn from a variety of practice experts including advanced practice clinicians, nurse executives, informaticists, or health policy-makers. A wide variety of public and private organizations are available for students. In general, post-master s students do not work with preceptors. They do, however, work with an organizational partner, as approved by the student s faculty advisor or chair who is familiar with the student s area of interest. An organizational partner serves as an advocate/facilitator for the DNP student and for the DNP Inquiry Project in the organization and to serve as a liaison for the organization to the SON. Selecting an Organizational Partner Organizational partners can present a variety of skills, educational credentials and expertise and may be selected from a variety of disciplines. The decision on what constitutes an appropriate organizational partner will depend on the route and area of academic and clinical interest of the student. The organizational partner must hold a position in the organization where he/she can facilitate the DNP student s access to clinical services, organizational information, decision makers, and other personnel in order to meet the DNP student s clinical experience objectives and implement the Inquiry Project during the practicum within the 56

63 organization. Organizational partners are recruited by the faculty. Students may also recruit a mentor for consideration by the faculty. Individuals who serve as mentors for graduate students in the Post-Master s DNP program should meet the following qualifications: 1. Formal education and professional experience as required for the professional role and practice; preferably an earned graduate degree or its equivalent in a specialty area of practice. 2. State licensure as required for the professional role and practice area if applicable. 3. Administrative or management expertise derived from practical and theoretical preparation for individuals in administrative or public health positions. 4. Commitment to assist students to meet defined learning objectives as established by the program of study. When possible and practical, the DNP student is encouraged to select an organizational partner outside of their current work setting. In large organizations the DNP student should conduct their practicum hours outside the department or unit where they are employed if possible. The line between current employment and clinical application hours and project(s) must be clear to the organization, the organizational mentor, the faculty, the DNP Inquiry Project Committee, and the DNP student. Evaluation of Clinical Application Hours When students are enrolled in their clinical application courses, they are required to maintain a log which records hours completed and a reflective journal of their experiences. Throughout the semester students are required to submit their journals via Bb Learn and they are reviewed by the faculty for meeting the clinical hour requirements and content. At the end of the semester, the clinical application will be graded on a pass/fail basis. In conclusion, the SON has faculty members, practice resources, and an academic infrastructure that supports a high quality educational program and provides students with the opportunities to develop expertise in nursing practice. The SON also provides infrastructure for extensive collaborative relationships with practice systems or sites and provides practice leadership in nursing and other fields. DNP Scholarly Inquiry Project Process All DNP students will prepare an Inquiry Project that demonstrates the student s in-depth knowledge of one's area of specialty practice and the synthesis of the student s coursework and practice application. The Inquiry Project is guided and evaluated by a faculty committee chair and inquiry project committee. The Inquiry Project results in a scholarly paper and presentation. 57

64 The focus of all DNP Inquiry Projects is on knowledge translation in an area of specialty practice at multiple system levels. Early in their program, students work with faculty to begin exploring concepts related to their area of interest while evaluating sources of evidence related to the problem/need. The inquiry is further defined throughout the program and the proposal written during the DNP Advanced Nursing Seminar (NURS 7111) course. Based upon an assessment and evaluation of the evidence, the plan and design will be developed for an Inquiry Project initiative. During the final semester the students will implement and report on their Inquiry Project. At the end of this final semester the student will present and defend their completed Inquiry Project. Students work closely with their Inquiry Project Committee, under the direction of the Committee Chair. The Committee is engaged in all aspects of the process. Selection of Inquiry Project Committee Chair and Committee The Inquiry Project is supervised by a faculty committee comprised of a minimum of two qualified members which includes the chair. The chair for the student s scholarly Inquiry Project must be a member of the School of Nursing faculty with the requisite expertise and experience to provide substantive assistance and direction to the student. Selection of the chair will be done by the student in consultation with either his/her student advisor, course faculty and/or Program Director. The Committee Chair must be faculty of the School of Nursing (SON) and hold a doctoral degree. The Chair is selected to match the scholarly interest and/or method of inquiry identified by the student. The Chair will meet with the student to plan the Inquiry Project and discuss the organizational partner and practicum site for the project, if not previously selected. Additional member(s) for the Inquiry Project Committee are selected based on their specific strengths and perspective they will bring to the problem or topic being addressed in the Inquiry Project. The Chair will assist the student in selecting the other committee member(s). The other member may be a SON faculty or an outside expert or organizational mentor. It is recommended that the second committee member is from the organization where the student is implementing the Inquiry Project as this member will serve as an advocate/facilitator for the student in the organization. Students may select more members for their committee based on project needs. Students will identify their Inquiry Project Committee Chair and committee member(s) and meet with their Chair at least once before they begin the Advanced Nursing Seminar course (NURS 7111). The Chair will also monitor and evaluate the organizational partner and practicum site. The Inquiry Project Committee is responsible for the following activities: 1. guide the student in the development of the Inquiry Project, 58

65 2. critique the readiness of the project proposal for presentation, 3. mentor the student during the implementation and scholarly reporting phases of the project, and 4. evaluate the student s performance on both the proposal and final Inquiry Project presentation Review Institutional Board (IRB) Inquiry Projects may require review by the University of Texas Health Science Center (UTHSCSA) Institutional Review Board (IRB) to establish benefits and risks and the need for protection of human subjects prior to the implementation of the project. To protect human subjects, IRB review is indicated. The IRB at UTHSCSA policies for human subjects protection reflect national standards of compliance with the Office for Human Research Protection of the Department of Health and Human Services (Title 45, Part 46). Completion of the Human Research Curriculum (CITI Collaborative Institutional Training Initiative) is required prior to the submission of the online application. This web-based training is available on the UTHSCSA IRB web site: The CITI training is usually completed in conjunction with the Design & Analysis for EBP Translational Science II course. The IRB application is submitted only after the Chair has reviewed and approved the application. A copy of the IRB letter of approval must be submitted to the Chair and Program Director before implementation of the project. Additional IRB approvals and CITI training may be required from the agency or institution in which the project will be implemented (see DNP Handbook, pp. 24 and 78-81). Inquiry Project Proposal The development of the proposal takes place during the Advanced Nursing Seminar course (NURS 7111). This seminar is structured to include a variety of activities related to the identification of the practice gap, refining their practice question, organizational assessment, literature synthesis and evidence for their theory based organizational intervention at multiple system levels. The student will provide drafts of the written proposal to the Committee Chair and make revisions based on feedback from the Chair. Once the proposal is finalized and reviewed by the Committee Chair, the student will present the proposal with their full committee in attendance. It is the student s responsibility to schedule the proposal presentation after coordination with the chair and committee members. The student delivers a 20 minute PowerPoint assisted presentation to their committee describing the key components of the project proposal. The 59

66 student provides a copy of the proposal to each committee member for their review at least two weeks before the proposal presentation. The DNP student must pass the proposal presentation before they can progress to the implementation phase of their Inquiry Project. A written evaluation with recommendations as appropriate will be given to the student at the completion of the presentation. Final Defense of the Inquiry Project The DNP student must successfully complete the final Inquiry Project Paper and oral presentation to be eligible for graduation. The chairperson, in consultation with committee members, determines when the final draft of the Inquiry Project is ready for defense. The DNP Inquiry Project Defense is a public presentation of the completed project. This defense is open to the public, including faculty, students and individuals outside of the University. All committee members are expected to be in attendance. All presentations must be scheduled ahead of time in coordination with the Chair, Committee members, and the DNP Program Director. The presentation will be facilitated by the Committee Chair. The DNP student will make a PowerPoint presentation of his/her project lasting approximately 20 minutes and should include a statement of the problem, review and synthesis of the literature, a description of the project implementation to address the problem, the evaluation results and implications for future work in this area. The presentation is followed by a private question and answer session with the student by the Inquiry Project committee. Following this session the student is excused and the committee will determine the results of the examination. Results of the examination will be reported to the student at that time. All members of the committee will sign the DNP Inquiry Project Evaluation Form 703. The form must be submitted to the DNP Program Director who will sign the form and forward it to the Office for Academic Affairs. The project must be successfully presented at least three weeks prior to semester end for the student to be eligible for graduation. This allows the student time to make any corrections to the final project that is requested. Once the Committee has agreed that the student has met all the requirements for graduation, the student will submit an electronic version of the final written paper to the DNP Program Director, Committee Chair, Committee Members and Associate Dean for Academic Affairs. Faculty has been discussing how to proceed in the event that a student is unsuccessful passing the final inquiry project presentation. Discussions have included establishing a mechanism for the student, committee members, and the DNP Program Director to mutually develop a plan for remediation. Consideration to establish a policy that failure to pass the 60

67 second presentation would result in dismissal is also been explored. Faculty are in the process of finalizing inquiry project policies for presentation to the COGS. The project must be successfully presented at least three weeks prior to semester end for the student to be eligible for graduation. Once the Committee has agreed that the student has met all the requirements for graduation, the student will submit an electronic version of the final written paper to the DNP Program Director and the Office of Academic Affairs. III-E. The curriculum and teaching-learning practices consider the needs and expectations of the identified community of interest. Elaboration: Teaching-learning practices are appropriate to the student population and build on prior learning. Teaching-learning practices consider the needs of the programidentified community of interest (e.g., use of distance technology, simulation, adult learner needs, second language students). Program Response Students are the key stakeholders in the SON s community of interest. They are the individuals who directly and indirectly influence and inform curriculum development and teaching-learning practices. However, the needs and expectations of other stakeholders identified in SON definition and model of the communities of interest are also considered by the faculty of the SON when curriculum and teaching learning discussions are entertained. A number of strategies have been described throughout this document which invite and encourage individuals and groups from both internal and external of communities of interest to participate in curriculum planning and implementation. Students are invited to be part of SON governance formally as members of standing committees and informally through discussions with faculty and deans. Clinical agency and organizational partners have participated in discussions and planning for implementation of new offerings in the graduate program, such as the DNP program. Formal mechanisms are in place to seek feedback which informs curricular decisions. Faculty seek feedback from students regarding appropriateness and effectiveness of teachinglearning strategies by means of course, clinical, and instructor evaluations; and, program exit and alumni surveys. When data indicate a downward trend in any given area, the faculty analyze issues that may affect this trend and adjust strategies accordingly. Informal feedback also informs the curriculum processes beginning in individual courses all the way through curriculum or policy revision. Prospective applicants provide feedback about the web site and various elements of the application process as they call in to the OASS, or interact with admissions personnel at Open Houses and other off campus recruitment activities. Residents in San Antonio recognize the School as an eminent nursing school in the region that expects excellence from its faculty, students, and graduates in the delivery of safe, 61

68 quality nursing care. With individuals of Hispanic origin representing more than 50% of the local population, unique opportunities are present for curricular and faculty development, scholarship, and practice. The first exit survey for the first graduating class of the SON DNP program will be conducted in the spring of Alumni will be asked in the spring of 2014 and every year and every three years thereafter to participate in post-graduation surveys. Data from these surveys will be used to inform curricular revisions. III-F. Individual student performance is evaluated by the faculty and reflects achievement of expected individual student learning outcomes. Evaluation policies and procedures for individual student performance are defined and consistently applied. Elaboration: Evaluation of student performance is consistent with expected individual student learning outcomes. Grading criteria are clearly defined for each course, communicated to students, and applied consistently. There are processes by which the evaluation of individual student performance is communicated to students. Student performance is evaluated by faculty. In instances where preceptors facilitate students clinical learning experiences, faculty may seek input from preceptors regarding student performance, but ultimately faculty are responsible for evaluation of individual student learning outcomes. The requirement for evaluation of student clinical performance by qualified faculty applies to all students, including those enrolled in post-master s DNP programs. CCNE recognizes that faculty evaluation of student clinical performance may be accomplished through a variety of mechanisms. Program Response The process for evaluating individual student performance is defined and clearly communicated to the students by faculty through course syllabi. Evaluation strategies are consistently applied. Course syllabi are made available to all students on the SON website prior to the beginning of each semester at Each syllabus has a section labeled Criteria for Evaluation/Grades under which the activities that will be used to assess learning are described as well as the criteria for arriving at the course grade. Faculty are responsible for evaluating student performance. Individual student outcomes reflect the program outcomes and are congruent with the School of Nursing mission, goals and aggregate outcomes. More complete information regarding grading and evaluation criteria is delineated in the SON DNP Student Handbook ( pdf). The handbook includes: SON philosophy regarding examinations and policies governing examination administration and grading; guidelines for written work which include guidelines for documenting sources used in written assignments; repetition of failed courses; advisement for students being readmitted to the undergraduate program following a failure in one course; and the process for applying for readmission are elaborated. The grading scale is 62

69 published as are policies related to progression in the either program, computation of GPA, and criteria for probation and dismissal. Student performance is evaluated by a variety of methods such as exams, formal papers, individual/group presentations and class participation activities. For example, in the first leadership course (NURS 7311) students were assigned to do a weekly reflective journal about insights gained regarding change and their leadership abilities while reading Robert Quinn s book Deep Change. Students chose 2 questions at the end of every chapter to reflect upon. At the end of the semester, the students summarized the insights gleaned from this reflective exercise (See Resource Room, III-F-1, Reflective Journal Assignment). Refer to Standard III-D for discussion on teaching-learning practices and environments which support the individual student learning outcomes and aggregate student outcomes. Faculty are accountable and responsible for developing a fair and equitable evaluation process and providing appropriate and sufficient learning opportunities to achieve clinical outcomes. Students are responsible and accountable for engaging in the learning. III-G. Curriculum and teaching-learning practices are evaluated at regularly scheduled intervals to foster ongoing improvement. Elaboration: Faculty use data from faculty and student evaluation of teaching-learning practices to inform decisions that facilitate the achievement of individual student learning outcomes. Such evaluation activities may be formal or informal, formative or summative. Curriculum is regularly evaluated by faculty and other communities of interest as appropriate. Data from the evaluation of curriculum and teaching-learning practices are used to foster program improvement. Program Response The faculty regularly evaluates the curriculum and teaching learning practices through meetings between the program directors and the track coordinators and through its committee structure. All curricular changes and revisions originate with the faculty members in the SON. The DNP program governance resides in the SON. The SON is responsible for assuring policies and procedures that are consistent with the UTHSCSA. Oversight of the DNP program resides with the DNP Program Committee. At present this committee is autonomous but plans for the future are to formalize the DNP Program Committee within the faculty bylaws. The committee reports to COGS, Faculty Council and Faculty Assembly. The DNP Program Committee meets monthly. Student evaluations of the overall program, as well as individual courses and faculty concerns, are reviewed. Based on discussions, recommendations for curriculum or policy changes may be made and forwarded through the SON committee structure for approval. The initial DNP Program Committee was November At this time the committee was open to all faculty to get input from and update them on the DNP proposal changes and 63

70 state approval status by the Texas Higher Education Coordinating Board (THECB). After the THECB site visit, the committee members were from faculty that teach in the program, Program Directors, Coordinator of the Nurse Practitioner track, Chairs, and Associate Dean for Academic Affairs. Committee meetings are also open to all who wish to attend. The committee creates and evaluates program policies and procedures, reviews admission requirements and recommends changes, develops and revises existing curriculum, approves sequencing of courses and reviews DNP student admissions (See Resource Room, Standard III-G-1, DNP Program Committee Minutes). Although there is no formal DNP student representation on the program committee at this time, student input is obtained from the students presently in the program. For example, DNP students indicated a preference that the DNP courses be offered in a distributed-learning format, that is face-to-face meetings throughout the semester instead of meeting in an executive fashion (classes meeting in the beginning of semester, middle and end of semester). This student information was discussed along with input from community partners and the decision was made by the committee to schedule courses so that classes meet fact-to-face, five to eight times spread throughout the semester, with the remainder of the course work conducted online. The Committee on Graduate Studies (COGS) addresses issues related to the planning, development, implementation, regulation and revision of curricula across the graduate programs offered by the SON in order to achieve the stated goals. Once recommended revisions are approved by COGS, the proposed changes are then considered by Faculty Council. The proposals and recommendations then go to the Faculty Assembly for final approval. Both formative and summative evaluations are used for purposes of evaluating teachinglearning practices from varied sources on a regular and recurring basis and are used to inform decisions that facilitate achievement of individual student learning outcomes. For example, at the end of each term students are asked to complete evaluations of each course. Examples of student responses are discussed in greater detail in Standard IV-B. From fall 2010 through summer 2011, the evaluation process was carried out by support staff from each department who distributed evaluation forms to the students on the last day of each class at the request of the teacher or course coordinator. In fall 2011, the SON implemented the web-based student ratings of instruction system offered through the Individual Development and Educational Assessment (IDEA) Center. This assessment service requires a minimum enrollment of three students in a course if it is to be evaluated. The IDEA evaluations were ed to students in DNP courses that had a total enrollment of three or more individuals. Courses with less than three students were not evaluated (see Appendix III, Table III-G-1, Course Evaluation Summary and Resource Room III-G-2, DNP Course Evaluations) 64

71 Results are shared with the Department Chair for use in annual faculty performance evaluation. Aggregate results are also compiled by the Assessment Specialist in the Office of the Associate Dean for Academic Affairs and the DNP Program Director to be shared with the DNP Program Committee and the COGS for use in curriculum evaluation and improvement projects. The faculty in team taught courses meet regularly to discuss the results of evaluations as a means to improve teaching learning strategies and to assess areas for improvement within the individual course. Faculty also assess student individual outcomes during the progression of the course. Details of the program evaluation plan are described in Standard IV. Strengths The faculty teaching in the DNP program are all involved in curriculum review and revisions. They have taken full advantage of opportunities offered to hone and develop teaching and learning strategies in the interest of developing and transforming the curricula to meet the needs of current students and to maintain congruence with professional standards and SON and UTHSCSA missions and goals. The faculty learned and incorporated new and more comprehensive approaches to teaching-learning practices and assessment strategies. The faculty followed a very deliberate approach to curriculum development and revision which clearly identifies a relationship to SON mission, and professional standards as well as providing a strong curricular foundation that guides student learning and assures that appropriate aggregate outcomes are achieved. Partnerships with clinical mentors and organizational partners are strong, but have grown stronger with the arrival of Dean Breslin. New funding and capital improvement initiatives such as classroom upgrades have made it possible for the SON to implement innovations in teaching learning practices. Areas for Improvement The SON is continuing to fully implement and evaluate the effectiveness of the curriculum. 65

72 Standard IV Program Effectiveness: Aggregate Student and Faculty Outcomes The program is effective in fulfilling its mission, goals, and expected aggregate student and faculty outcomes. Actual aggregate student outcomes are consistent with the mission, goals, and expected student outcomes. Actual alumni satisfaction data and the accomplishments of graduates of the program attest to the effectiveness of the program. Actual aggregate faculty outcomes are consistent with the mission, goals, and expected faculty outcomes. Data on program effectiveness are used to foster ongoing program improvement. IV-A. Surveys and other data sources are used to collect information about student, alumni, and employer satisfaction and demonstrated achievements of graduates. Collected data include, but are not limited to, graduation rates, NCLEX-RN pass rates, certification examination pass rates, and employment rates, as appropriate. Elaboration: Processes are in place for regular collection of aggregate student outcome data. For entry-level programs, the program indicates whether NCLEX-RN pass rate data represent first-time takers and/or repeat takers. The program is expected to demonstrate how RN-to-baccalaureate program graduates as well as pre-licensure graduates achieve the expected outcomes of the baccalaureate program. Certification pass rates are obtained and reported for those graduates taking each examination, even when national certification is not required to practice in a particular state. Program evaluation data are collected on a regular basis. For each degree program, the program calculates graduation rates (number of students completing a program divided by number of students entering a program). The program specifies the entry point and the time frame used in the calculation of graduation rates. Individual programs may collect additional aggregate outcome data related to other aspects of their mission, goals, and expected student outcomes (e.g., enrollment in further graduate education). Program Response The Total Program Systematic Evaluation Plan (TPSEP) specifies the evaluation process used by the School of Nursing (SON) to collect program evaluation data (Resource Room IV-A-1, Total Program Systematic Evaluation Plan). The DNP Program Assessment Plan maps each program outcome to a specific outcome measure and specifies benchmarks for expected student outcomes which are compared to actual student outcomes. The DNP Program Assessment Plan is represented in Appendix IV, Table IV-A-1 and depicts the specific measures and benchmarks. The SON also utilizes a number of surveys and other data collection methods to assess the achievements of students and graduates on each of the program outcomes, as well as student and alumni satisfaction. For example, standardized instruments, such the AACN/Educational Benchmark Inventory (E.B.I) assessments, will be used near the end of the curriculum to assess student perception of their learning as well as satisfaction with the program. Program outcomes are measured using formative and summative evaluation methods, both formal and informal. Formative evaluation includes faculty observations and informal 66

73 conversations with students. Summative evaluation is gauged through aggregate data that includes course evaluations, evaluation of scholarly inquiry projects, graduation rates, job placement and data indicating graduating students and alumni perceptions about program preparation and achievement of program outcomes. Also, students accomplishments are reflected in publications, presentations, and awards. Formative and summative evaluation data are collected and analyzed each semester and presented to the DNP Program Committee and COGS annually for review and recommendations for curricular improvements. Because the first group of DNP students (N=3) are slated to graduate in May of 2013, data for graduation rates, job placement, and graduating students and alumni perceptions about program preparation and achievement of program outcomes are not available. IV-B. Aggregate student outcome data are analyzed and compared with expected student outcomes. Elaboration: Actual student outcomes data are analyzed in relation to expected student outcomes to identify areas of discrepancies. Discrepancies may indicate areas for program improvement. Program Response Data are analyzed to identify areas of discrepancies which may indicate the need for ongoing program improvement. Findings are presented to the DNP Program Committee and COGS for review and recommendation for curricular improvements. Summative Evaluations Course Evaluations Course evaluations are conducted using the Individual Development and Educational Assessment (IDEA). Each semester the IDEA course evaluation is sent to students by the Office of Academic Affairs electronically via their Liv accounts within a window of 2 weeks before and 2 weeks after the conclusion of course instruction. The evaluation consists of 3 parts: 1) student ratings of leaning on relevant course objectives/outcomes, 2) description of the level of academic challenge and the student s academic motivation and work habits, and 3) students perception of teaching methods and styles to include the instructor s ability to stimulate student interest, fostering student collaboration, establish rapport, encourage student involvement and structure the classroom experiences. Faculty members have determined which of the relevant course objectives/outcomes are essential to student learning for each course in the degree program. Course evaluation data has been analyzed for academic year and These findings were presented to the COGS on January 4, Targets were met in with the exception of the courses mapped to Program Outcome 2 (NURS 6353, 67

74 Transforming complex Healthcare Systems for Quality and Safety) and Program Outcome 7 (NURS 6380, Fundamentals of Epidemiology). Eighty-eight percent (88%) of the students who responded to course evaluation in Transforming Complex Healthcare Systems for Quality and Safety, (NUR 6353) chose agree or strongly agree to indicate that the courses prepared them to meet expected learning outcomes in Students commented that the amount of coursework was overwhelming and one student commented the faculty was slow to respond. After reviewing student comments, the faculty decided to continue to monitor for trends. In the subsequent course evaluations showed that the benchmark was met and problem rectified itself. Seventy-eight percent (78%) of the students who responded to course evaluation in Fundamentals of Epidemiology, NUR 6380 chose agree or strongly agree to indicate that the courses prepared them to meet expected learning outcomes in Qualitative comments indicated that students wanted more face to face times and that some of the content was difficult to grasp. As a result of student comments, the course was revised to increase class sessions by 2 additional meetings and to expand office hours to include both face-to-face and on-line meetings. In , the benchmark was met. The COGS recommended to that faculty continue to monitor the course evaluation until more data is available and course trends can be identified. These recommendations were forwarded and approved by Faculty Council on January 14, 2013 and by Faculty Assembly on January 25, 2013 which is the final review and approval body. Final reports were sent the Vice President for Academic, Faculty, and Student Affairs to include in the University assessment plan for determining institutional effectiveness. Results from course evaluations are sent to individual faculty members, the Department Chairs and the Associate Dean for Academic Affairs. Aggregate findings are reviewed by the Committee on Graduate Studies as part of the Program Assessment Plan. Course evaluation data has been collected for academic years and Table IV-A-2 Program Assessment Report Course Evaluations summarizes the results student ratings of leaning on relevant course objectives/outcomes. The detailed findings are is available in the Resource Room, Standard IV-B-2, DNP Program Assessment report. Individual Course Evaluations are available in the Resource Room, Standard III-G-1, DNP Course Evaluations. 68

75 Table IV-B-2 Program Outcomes Report Course Evaluations Program Outcome Course Students Target Findings Integrate nursing science, ethics, biophysical, psychosocial, analytical, and organizational sources to provide the highest level of specialty nursing practices. Develop, implement, and evaluate healthcare practices in healthcare systems that ensure quality improvement and patient safety. Use analytic methods and evidencebased practices to improve practice outcomes and the practice environment. Implement and evaluate ethical healthcare information systems and patient care technology to improve the quality of patient health outcomes and care systems. Advocate for healthcare practices that advance social justice, equity, and ethical policies within all healthcare arenas. Employ inter-professional collaborative teams to improve patient and population health outcomes and healthcare delivery systems. Lead the integration and institutionalization of (evidencebased) clinical prevention and population-based health guidelines. 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 (6323), Theories & Research 6353 (5353) Transforming, 7222 (6222) Leadership 7324 (5091) HC Economics 6317 (5317), Informatics 7222 (6222) Leadership 6322 (7322) HC Policy 6353 (5353), Transforming 7222 (6222) Leadership 6380 Epidemiology 7111, 7511, Adv Nsg 7312, 7313 DNP Project Inquiry 4 90% of the students will choose substantial to exceptional progress in meeting expected learning outcomes % chose substantial progress 63% chose exceptional progress. 40% chose substantial progress 50% chose exceptional progress. 3 33% chose substantial progress 67% chose exceptional progress. 1 40% chose substantial progress 50% chose exceptional 6 progress. 3 60% chose substantial progress 40% chose exceptional progress. 2 39% chose substantial progress 51% chose exceptional 6 progress. 1 44% chose substantial progress 35% chose exceptional progress. Course not offered Course not offered Graduation Rates The Associate Dean for Academic Affairs is responsible for tracking student progression and graduation. The graduation rates are calculated at the end of each fiscal year. Students are tracked from the date of enrollment to graduation or to their exit from the program for other reasons, such as voluntary withdrawal or academic dismissal. The THECB mandates that doctoral students be allowed ten (10) years to complete their program of study. However, the expected outcome for the DNP Program is that 100% of the students in any cohort will graduate 69

76 in five (5) years. As students from a cohort graduate at three, four, and five years the cumulative graduation rate is calculated based on the number of students graduated divided by the number of students entering the cohort. However, annualized rates (those reported by THECB as the percent of students in an entering fall cohort for a specific degree program who graduate within 10 years) are generally more helpful and are used to track overall achievement of program outcomes or to evaluate the influence of programmatic changes on graduation rates. Of the seven (7) post-msn students who began coursework in the fall of 2010 and one (1) in the spring of 2011, five (5) students were officially admitted to the program in the summer of Of the 2010 and 2011 cohorts, two (2) students have withdrawn from the program. One student moved to the Post-MSN Certificate program in Fall 2012 to complete course work as a Psychiatric Mental Health Nurse Practitioner and will enter the DNP program in summer Of the remaining five (5) students, three (3) of these students are on track to graduate in the spring of 2013 and two (2) students are on track to graduate in the summer of Eighteen (18) students were admitted in the fall of 2012 and two (2) students are currently on a leave of absence (see Table IV-B-3, DNP Attrition Rates for Fall 2010, Spring 2011, and Fall 2012 Admits). Table IV-B-3 Post-MSN DNP Attrition Rates for Fall 2010, Spring 2011, and Fall 2012 Admits Fall 2010* Post-MSNs begin coursework Number Admitted Moved to Another Program LOA a Voluntary W/D b Dismissed c N N N % N % N % % Spring % Fall % 2 11% New Post-MSN students Total Note. The following abbreviations were used: WD =Voluntarily Withdrew; a = Number (%) who voluntarily withdrew or took leave of absence from the program; b = Number (%) academically dismissed from the program * Remaining Fall 2010 Post-MSN students officially admitted to DNP in Summer 2012 The faculty are in the process of establishing benchmarks for attrition rates. Exit Surveys Exit Surveys are used to measure demographic variables and satisfaction with varied aspects of the nursing educational experience. The AACN/ Educational Benchmark Institute (EBI) Doctor of Nursing Practice Exit Assessment elicits information regarding satisfaction with the instruction and curriculum; achievement of program outcomes that underpin the DNP 70

77 graduate curricula; educational preparation; professional achievements and plans for employment The survey will be customized to include program outcomes specific to the SON DNP program. Surveys will be distributed to graduating students electronically via their Liv accounts by the Office of the Associate Dean for Academic Affairs upon completion of their program of study. The data will be analyzed and sent to the Committee on Graduate Studies for review and recommendations for curricular improvements. A copy of the AACN/EBI Exit Assessment can be found in the Resource Room, Standard IV-A-4, AACN/EBI Doctor of Nursing Practice Exit Assessment. Alumni Surveys The AACN/EBI DNP Alumni Survey was recently adopted to replace the SON-developed survey to collect program outcome data, such as the graduate s self-evaluation of preparation for practice. The survey will be customized to include program outcomes specific to the SON DNP program. The Alumni Survey will be sent to all graduates at one year and three years postgraduation. Job Placements Data regarding job placement will be collected as part of the AACN/EBI alumni survey Inquiry Projects An additional way of gauging whether students reach the desired outcomes is through examination of their DNP Inquiry Project content. Students have criteria which they must meet to plan, implement, and evaluate their projects and document the process. These criteria reflect expected outcomes for students (see Resource Room, Standard IV-A-7, Criteria for Inquiry Project). Therefore, successful completion of the Inquiry Project is additional documentation that expected student outcomes are met. A list of DNP graduates, titles of their scholarly projects, and chair and committee members can be found in Table IV-B-4, Inquiry Projects. Table IV-B-4, Inquiry Projects Title Inquiry Project Chair/Advisor Organizational Partner and Committee Implementation of an Evidence-Based Intervention to Reduce Readmission Due to Pneumonia from Nursing Home Facility to Acute Care Carole White, PhD, BSN Diane Rudolph, DNP, RN, GNP-bc Designing a Comprehensive Pain Management Bundle for Nursing in a Small Community Hospital A Systems Design for Integration of Advanced Practice Nurses and Physician Assistants Mickey Parsons, PhD, RN Mickey Parsons, PhD, RN Joyce Batcheller, DNP, RN, NEA-BC (Chief Nursing Officer/ Senior VP) Joyce Batcheller, DNP, RN, NEA-BC (Chief Nursing Officer/ Senior VP) 71

78 Publications and Presentations Data about the number of publications and presentations are collected by the Office of Academic Affairs. DNP students had 1 scholarly presentation (see Table IV-B-5, Scholarly Presentations. Table IV-B-5, Scholarly Presentations Title of Presentation Reflective Journaling for Advanced Nurse Practice: Use of Reflective Journaling in a Doctor of Nursing Program Leadership Course Conference 33 rd International Association for Human Caring Annual Conference in Philadelphia in 2012 Awards The University of Texas Health Science Center at San Antonio-School of Nursing awards education scholarships and grants with help from foundations within the community to assist students in obtaining college degrees in the healthcare field by fostering and funding clinical, educational, spiritual and scientific initiatives. These awards help a diverse population of students in the Doctor of Nursing Practice (DNP) program. Highlights: In summer 2012, Methodist Health Foundation awarded six (6) students $2,000 each for a total in aid awarded $12,000. In fall 2012, Baptist Health Foundation awarded ten (10) student $5,000 each for a total in aid awarded of $50,000. Methodist Health Foundation awarded six (6) students $5,000 each for a total in aid awarded $27,000. In spring 2013, Methodist Health Foundation awarded twelve (12) students $2,000 each for a total in aid awarded $44,000. $90,000 $80,000 $70,000 $60,000 $50,000 $40,000 $30,000 $20,000 $10,000 $0 Summer 2012 Fall 2012 Spring Aid # Students 72

79 IV-C. Aggregate student outcome data provide evidence of the program s effectiveness in achieving its mission, goals, and expected outcomes. Elaboration: The program reports aggregate data related to its expected outcomes. Reported data include student, alumni, and employer satisfaction; graduation rates; NCLEX- RN pass rates; certification examination pass rates; employment rates; as well as data related to other program-identified expected outcomes. Program Response: The program collects information related to expected individual and aggregate student outcomes, graduate, and alumni satisfaction according to a defined process at scheduled periods as specified in the Total Program Systematic Evaluation Plan. Assessment measures have been mapped to program outcomes. Faculty are in the process of aligning the SON mission and goals to the newly revised University Strategic plan for and mapping program outcomes to the mission and goals. The Associate Dean for Academic Affairs is involved with all evaluation processes from individual to aggregate levels to help assure achievement of program outcomes. Data collection processes and outcome indicators were described under Standard IV Key Element A. Process improvement efforts are undertaken when outcomes are not met. The data that is available at this point indicate that ongoing students are achieving, or approaching achievement of expected outcomes. Preliminary data suggests that the program is effective. IV-D. Aggregate student outcome data are used, as appropriate, to foster ongoing program improvement. Elaboration: The program demonstrates use of aggregate student outcome data for program improvement when actual outcomes are not consistent with expected outcomes. Adjustments to foster ongoing program improvement are deliberate and congruent with the mission, goals, and expected student outcomes. Program Response: Aggregate student outcome data are reported annually to faculty and administration through the SON committee structure. The SON has established a process for program improvement when actual outcomes are not congruent with expected outcomes. The faculty has established processes in place that assure that consistent evaluation and appropriate use of outcome data are included in plans for program improvement. Data related to aggregate student outcomes are used during curriculum evaluation. The DNP program faculty meets monthly to review courses, content placement, and relationships with organizational partners. Adjustments are made in specific areas as needed. The COGS conducts a systematic review of all graduate level courses every other year. Adjustments to foster program improvement are made based on this review. Table IV-D-1, Examples of Program Improvements, depicts the program improvements based on review of the curriculum 73

80 Table IV-D-1, Examples of Program Improvements Review and Evaluation Dr. Kendall-Gallagher designed a survey to evaluate her class NURS 7322 Healthcare Policy Analysis & advocacy and NURS 7324 Healthcare Economics and Policy taught by Dr. Carol Reineck. These courses were tied together by a final class presentation for both classes were the economics analysis was integrated in to the Advocacy presentation and paper. The survey was conducted as part of an education class Dr. Kendall-Gallagher was taking at the UTHSCSA. Dr. Mickey Parsons uses a group process strategy (OARRR) to begin every course (NURS 7314, NURS 7111 and NURS 7312). This approach allows her to get acquainted with each student with their learning goals and keep that in mind for leadership, management, practice, examples as the course progresses based upon the course objectives. She also does a review at the end of each class so she has on-going feedback which helps her to be more effect and better facilitate their accomplishment of the course objectives and personal learning goals. Dr. White s discussion with the program committee and input from student performance and inquiries from NURS 7314 and NURS NUR 7311 Faculty Evaluation of the first time course offered. Curricular Improvement The faculty was not sure how blending the two classes together would work for the students. The question was asked: Did integrating components of your economic analysis into your selected advocacy model add value to the learning process? All five (5) students responded yes. Example: Yes, I recommend these two classes remain partners - The Faculty is presenting this course again with integrating components of both courses. What could be improved in this course? The students responded that they would like to have time to work with Legislators and see actual advocacy papers. This year the healthcare policy course was changed to accommodate students working with more hands-on legislative experience. They also received copies of advocacy papers for review. She used all of this formative evaluation data based upon the student feedback from NURS 7314 and NURS 7111 (NURS 7312 is ongoing) to make her recommendations to the program committee meetings in which curriculum change was discussed. Input helped the committee to improve the Inquiry Project and to update our evidencebased courses to facilitate the DNP proposal process (more method design added). Redesigned NURS 7321 Statistical Analysis to include run charts and statistical process control charts into the course. As well, the class has become more applied with much more attention to interpretation of the statistic utilized in articles and the results. Also in NURS 7301 EBP Translational Science I, rather than having the students do a number of assignments related to critical appraisal in the class and then their final project, the assignment for the class have been updated so that every assignment builds on their final synthesis paper. For example, they appraise quantitative and qualitative articles that they will use in their final paper and they build the tables that will also be part of their final paper. Dean Breslin and Dr. Kendall-Gallagher redesigned N7311 course for the spring 2011 semester and then updated the course for the fall 2013 semester. NURS 7311 Theories and Research in leadership, quality, safety and evidence base was updated by Dr. Breslin and Kendall-Gallagher by expanding focus on strategic thinking and adaptive leadership. In working with the program committee we felt that this 74

81 Table IV-D-1, Examples of Program Improvements Review and Evaluation Curricular Improvement leadership course set the tone for the students professional journey and captured the leadership threads that are present throughout the DNP curriculum. The underlying assumption of this course is that the success of graduates with a Doctor of Nursing Practice (DNP) degree in transforming health care will depend significantly on their leadership ability to think strategically, innovate, and engage stakeholders in meaningful system improvement. The paper titled Developing DNP Students as Adaptive Leaders: A Key Strategy in Transforming Health Care has been accepted for publication in the Journal of Professional Nursing and will appear in the September-October 2013 issue. This paper is a nice exemplar of how the faculty develop curriculum. A copy of the manuscript is located in the Resource room, IV-A-1, Manuscript IV-E. Aggregate faculty outcomes are consistent with and contribute to achievement of the program s mission, goals, and expected student outcomes. Elaboration: Aggregate faculty outcomes reflect the program s mission, goals, and expected student outcomes. For example, if research is an identified element of the program s mission, faculty research productivity should be assessed as an expected faculty outcome. If research is not part of the identified mission, it would not be expected as a faculty outcome. Evaluation of faculty outcomes is consistent with the institution s and program s definition(s) of faculty role expectations. There is congruence between expectations of the faculty in their roles and evaluation of faculty performance. Program Response: The mission of the SON in keeping with the mission of the UTHSCSA is to make lives better through education, research, health care and community engagement. Evidence presented in Standard II demonstrates that the SON has adequate faculty resources to meet the teaching mission and that resources are available to faculty and students to support achievement of program outcomes. Strong evidence is presented to support conclusions that FTE numbers are sufficient to meet faculty outcomes Table IV-E-1, Promotion and Tenure Table IV-E-1, Promotion and Tenure Success Rates for SON Faculty Year Number Number Percent Applied Promoted/Granted Tenure % % % 75

82 Success Rates for SON Faculty shows a 100% promotion rate for SON faculty, and that 100% of faculty who have applied for tenure have been successful during academic years and In academic year , a decline in success rates occurred when one (1) assistant professor who applied for promotion to associate professor was denied and 5 instructors applying for promotion to assistant professor were denied. The departmental PTAC is mentoring faculty in meeting standards for promotion. Two of the faculty are reapplying for promotion this year. Faculty development support for teaching is available through varied UTHSCSA and external resources such as the AACN Doctoral conference. The SON also brings scholars to campus to support faculty development. Dr. Kikanza Nuri Robins came to the school to facilitate workshops and continuing education regarding cultural proficiency. All faculty were provided with a copy of the text, Cultural Proficiency: A Manual for School Leaders (Lindsey, Robins, & Terrell, (2009) as an aid to understanding and incorporation of cultural proficient strategies into the culture of the school. And, each new faculty is provided with a copy of Teaching in Nursing: A Guide for Faculty (Billings, & Halstead, 3 rd ED. 2009) as an aid to development in teaching.- Among the most important faculty development opportunities is the recent (May, 2010) SON policy outlining requirements and process for junior faculty pursuing doctoral education to obtain subsidies for their studies. Building a cadre of highly skilled, experienced faculty is an important value added approach for ongoing development of expertise in the School of Nursing relative to achieving the SON mission and goals. The SON also boasts 10 faculty members who have been elected Fellows of the American Academy of Nursing. Dr. Norma Martinez Rogers is Past President of the National Hispanic Nurses Association, Dr. Carol Reineck has served as Treasurer of National Organization of Nurse Executives, and Ms. Kathleen Reeves is immediate past President of the Academy of Medical Surgical Nurses (AMSN) recently received their President s Award, and serves on the ANA Council on Practice and Economics. Faculty are expected to engage in service and their efforts are supported. Faculty teaching is evaluated annually through course evaluations. Evaluation of teaching effectiveness is based on the review of the following: 1) review of the 20 teaching methods that are most related to learning on those objectives, 2) student s ratings on the faculty s use of those important methods, and 3) what changes should the faculty consider in their teaching methods. Suggested actions related to evaluating the need for change in teaching methods are based on comparison with ratings for classes of similar size and level of student motivation. Categories for suggested actions include 1) consider increasing use which means 76

83 that the faculty employed the method less frequently than those teaching similar courses, 2) retain current use or consider increasing which means the faculty employed the method with typical frequency, or 3) strength to retain which means that the faculty employed the method more frequently than those teaching similar courses. Students are asked to rate the extent to which faculty meet the specified criteria for teaching methods and styles on a scale of 1-5, with 1 being hardly ever and 5 being almost always. Although these data are used primarily to foster and facilitate course improvement, when the benchmark (retain to strength to retain) is not met consistently in an area identified with a specific faculty, the department chair may require the faculty to participate in faculty development programs to foster improvement and/or remove the faculty from the course. Table IV-E-II, Student Ratings of Teaching Methods and Style shows faculty teaching effectiveness for courses taught in Table IV-E-II Student Ratings of Teaching Methods and Style Suggested Actions for Teaching Methods Most Relevant to Objectives Course # of Respondents Increase Use Retain Strength to Retain NURS NURS *6353/ NURS NURS NURS *7222/ NURS *7301/ NURS *7311/ NURS NURS *7322/ NURS *7323/6323 **1 NURS *7324/ NURS 6317 Healthcare Information Systems and Patient Care Technology NURS 6353/5353 Transforming Complex Healthcare Systems for Quality and Safety NURS 6380 Fundamentals of Epidemiology NURS 7111 Advanced Nursing Seminar NURS 7222/6222 Leadership in Complex Healthcare Systems NURS 7301/6311 Methods for EBP Translational Science I NURS 731/6310 Theories & Research in Leadership, Quality, Safety, & Evidence Base NURS 7321 Statistical Analysis for Quality Improvement and Health Delivery Systems NURS 7322/6322 Healthcare Policy Analysis and Advocacy NURS 7323/6323 Design and Analysis for EBP Translational Science II NURS 7324/5091 Healthcare Economics and Policy *First number is current course number/second is previous course number. **Report could not be generated likely due to insufficient number of responses. Min (2) req. Faculty with greater than 50% appointments are expected to engage in scholarly activity and/or practice/service activities. The actual outcome reported in spring 2011 indicated that 77

84 100% of the faculty with greater than 50% appointments are engaged in scholarly and or practice/service activities. Research is an expected outcome for tenure track faculty. Therefore, the Office of Nursing Research and Scholarship provides support resources for faculty to develop and submit proposals to intramural and extramural sponsors as described under resources in Standard II Key Element B. The potential funders include the SON, The University of Texas, local, regional, national, and international institutions and foundations. Evidence presented in Appendix IV, Table IV-E-3 shows activities and productivity related to research/ discovery scholarship and demonstrates a consistent increase in both research funding for research and in the number of faculty submitting grants. Data in demonstrates that across the years from 2010 to 2013 faculty research productivity increased. Details regarding individual faculty productivity is available in Resource Room, Standard IV-E-1, Faculty Research Productivity. Faculty are disseminating research via publications as well as presentations at local, state, regional, national and international conferences. Examples of these work products are available in the Resource Room (Resource Room, Standard I-C-3, Faculty Teaching and Scholarship). Several faculty have been recognized for their scholarly contributions by their election to membership in various academies, or appointment to prestigious positions with professional organizations or government agencies, and their representation on national study sections. Clinical practice may also be an expectation of faculty..although faculty have previously participated in practice scholarship, the arrival of the Associate Dean for Practice/ Community Engagement has provided more opportunities and resulted in increased faculty participation. The Office of Practice and Engagement as described in Standard II Key Element B also provides opportunities to demonstrate innovative nursing practice and serves as a basis for scholarship of practice/community engagement. Faculty staff the UTHSCSA Student Health Center and the new Employee Health Center. New contracts have been established and others are in process. All agreements present opportunities to provide service to the UTHSCSA, the San Antonio community, and the South Texas region. In 2010 the School adopted a Faculty Practice Plan. This plan has been approved by the UT Systems and Board of Regents. We are awaiting final copy from legal counsel (Resource Room, Standard II-F-3, Faculty Practice Plan). Since that time, faculty have been both encouraged and provided with administrative support to develop innovative relationships with practice settings as described. This enterprise is in development stages, but has increased the number and variety of opportunities for faculty. Faculty participation in service to the UTHSCSA and SON is described in Standard I. All faculty are expected to participate in school and university committees and do. Faculty represent 78

85 the SON on most UTHSCSA committees. In summary, faculty outcomes in the areas of teaching, scholarship, service, practice and engagement are presented in Table IV-E-3, Aggregate Faculty Outcomes Table IV-E-3, DNP Faculty Scholarly Productivity Scholarly Activity Number of DNP Faculty Products Publications 35 Presentations 49 Grants 29 Service on SON Committee 13 Service on UTHSCSA Committees 31 Professional Organizations 60 In the analysis of faculty outcomes and expected student outcomes several examples were found as noted below: Program Outcome 1: Integrate nursing science, ethics, bio-physical, psychosocial, analytical, and organizational sources to provide the highest level of specialty nursing practices. Faculty who teach in the DNP Program have clinical expertise in all areas of student interest. These include faculty certified in advanced practice nursing roles and advanced levels of nursing administration. Students are assigned to faculty advisors based on mutual areas of interest and expertise. For example, Dr. Mickey Parsons who has her PhD in Health and Organizational Systems is the advisor for our Executive Administrative Management students. Dr. Parsons is nationally known in the area of administrative management, is a consultant to hospitals, community and state wide, for the Healthy Workplace Intervention program she designed and she was the previous coordinator of our MSN Administrative Management track. Program Outcome 2: Develop, implement, and evaluate healthcare practices in healthcare systems that ensure quality improvement and patient safety. Analyses of the ongoing Inquiry Projects for students of the DNP Program reflect their area of advanced practice, leadership and expertise of their faculty advisors and committee members. For example, one of the DNP students is an Adult/Geriatric nurse practitioner who is doing a study to implement an evidence-based intervention to reduce preventable hospital readmissions at Nursing Facility. Dr. White is her faculty committee chair whose expertise is evidence based practice and research in community outcomes of patient care. Her committee member is a DNP, geriatric board-certified nurse practitioner who is adjunct faculty at the UTHSCSA SON and has expertise in the care of patients in a nursing home environment. 79

86 Program Outcome 3: Use analytic methods and evidence based practices to improve practice outcomes and the practice environment. In order to help students use analytical methods and evidence to improve practice, faculty with expertise in these areas teach courses pertaining to these topics and act as advisors to students. For example, Dr. White, who has her PhD in Epidemiology and Biostatistics, and Dr. Kennedy, who has extensive background in clinical research, teach Statistics and Evidence-Based courses. Both professors work with students as faculty chairs and members of students Inquiry Project Committees. Dr. Herbold, faculty at the School of Public Health, teaches the Epidemiology course and is available to work with students on their projects. Program Outcome 4: Implement and evaluate ethical healthcare information systems and patient care technology to improve the quality of patient health outcomes and care systems. An analysis of how faculty impact the way that students solve problems that affect health and health care delivery through clinical leadership revealed that the faculty-guided problemsolving process takes place in courses with a practice application, including the informatics course. For example, a student is interested in redesigning the appointment process of an outpatient drug rehabilitation health clinic. This project was started in the informatics class under Angela Ross. Ms. Ross has extensive leadership experience in program and project management, strategic planning, program evaluation and informatics/information technology and policy development. She is currently finishing her DNP at the University of Maryland. With the input from Ms. Ross, the student designed an elaborate information process flow of his organization, calculated cost of the improved flow design and developed a strategic buy in process to make change. The student is currently developing this topic further into an Inquiry Project. This project would reduce the waiting times, decrease the agitation of patients waiting for their appointments, and improve patient center care at the facility. Program Outcome 5: Advocate for healthcare practices that advance social justice, equity, and ethical policies within all healthcare arenas. Faculty with expertise and demonstrated results in policy change teach courses specific to this area of expertise. For example, Dr. Kendall-Gallagher received her law degree in She served as a Legislative Drafter/Attorney Legislative Analyst/Attorney Advisor to the U.S. Department of Health & Human Services, Washington, DC, a Research Fellow for the Interdisciplinary Nursing Quality Initiative (INQRI) project at the University of Pennsylvania (in 80

87 partnership with the Robert Wood Johnson Foundation) and most recently is certified by The Dartmouth Institute Microsystem Academy Coach. Program Outcome 6: Employ inter-professional collaborative teams to improve patient and population health outcomes and healthcare delivery systems. All Inquiry Projects use inter-professional collaborative teams to improve healthcare outcomes. All students during their organizational assessments meet with stakeholders and form teams for their organizational improvements to occur. For example, one DNP is writing a policy paper to develop and implement a regional policy for the integration and utilization of acute care nurse practitioners into the adult intensive care unit of a health system. In order to accomplish this her collaborative team includes the systems Chief Nursing Executive (CNE), Chief Medical Officer, Vice President of Critical Care Services, Chief Intensivist, Hospitalist Medical Director and Intensive Care Unit nursing directors. Her committee member and organizational partneris the CNE who has her PhD in Nursing with a focus on Administrative Management. Program Outcome 7: Lead the integration and institutionalization of (evidence-based) clinical prevention and population based health guidelines. All students are required to evaluate how guidelines are developed and utilized in their organizations or not utilized. For example, one student who is a director of education for a large hospital in Houston looked at a guideline for nutrition support for patients in his hospital. Although the guideline was based on a national guideline, its context adaptation, implementation and dissemination did not include the appropriate team members. Therefore, the new institutional guideline was not being followed by the nurses who felt the guideline as written was not appropriate to their setting. The student put a stakeholder committee together and facilitated the use of the guideline. He presented his findings and strategy to his class for Design & Analysis for EBP Translational Science II. Program Outcome 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. Faculty expertise influences the students ability to improve patient, population, and health systems outcomes throughout their programs. Faculty with expertise in leadership, program planning, implementation and evaluation, including needs assessment, gap analysis, and economic considerations, work with and guide students in the classroom and simultaneously in clinical settings to promote specific student outcomes. 81

88 IV-F. Information from formal complaints is used, as appropriate, to foster ongoing program improvement. Elaboration: If formal complaints indicate a need for program improvement, there is evidence that action has been taken to address that need. Program Response: No formal complaints by students in the DNP program have been registered during the period of this review. The benchmark for this key element is that 100% of formal complaints indicating a need for program improvement result in appropriate faculty or administrative action. All students have access to the current UTHSCSA Catalog ( This document contains the necessary policies and procedures for filing student grievances and grade appeals. Student concerns, questions, and comments are addressed through the student s faculty advisor, at student forums, and through in-class feedback Organizational structures are in place to offset the need for formal complaints and address student concerns in a fair and timely manner. A process for tracking student complaints was approved by the faculty in September of The purpose of this policy is to provide a mechanism for tracking the timeliness of responses to complaints as well as the outcome of complaints. In addition, this policy provides a mechanism for identifying patterns or systemic problems with institutional quality or with factors related to the General Institutional Requirements or Criteria for Accreditation. The Associate Deans review student complaints and refer the complaints to the appropriate forum for exceptions to policies. The faculty, students, and administrators work together to negotiate a resolution to concerns that maintains the integrity of the academic processes and addresses ambiguous areas of concern. The policy is available in the Resource Room, Standard IV-F-1, Student Complaint Process. Strengths The SON has established a sound process for the assessment of student and faculty outcomes. The SON has engaged in a deliberative process to substantively revise the mission, goals, and curricula to foster ongoing program improvement. The SON has demonstrated significant improvements in terms of faculty outcomes in the areas of research funding and grant submissions; and in creating new enterprises for practice/community engagement. The SON is effective in achieving its mission and goals as well as those of the parent institution. 82

89 Opportunities for Improvement Increase the number of faculty promoted and tenured Action Plan: Capitalize on the newly established Department PTAC in guiding, coaching, and mentoring faculty from initial appointment through promotion and/or tenure. 83