STANDARD III PROGRAM QUALITY: CURRICULUM AND TEACHING-LEARNING PRACTICES

Transcription

1 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: Baccalaureate Program The baccalaureate program comprises two undergraduate options: traditional BSN and accelerated BSN. These options are designed to meet the needs of different student populations, trends in health care delivery systems, and more specifically, the nursing profession. The TO is designed for students who have completed high school or its equivalent while the AO is designed for students who have an undergraduate degree in a field other than nursing. The undergraduate curriculum is developed, implemented, and revised to reflect individual student learning objectives which are consistent with the mission and aggregate student outcomes. Curriculum assessment is carried out as described in the CAP Section III.A (ERIII-1). In 2009, faculty responded to the change in The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008) by revising the college mission (ERIII-2) and student learning outcomes (ERIII-3). Course objectives were revised to be congruent with the new student learning outcomes (ERIII-4). A series of five faculty workshops were conducted to map course content to the new course objectives and student learning outcomes (ERIII-5). A copy of the undergraduate curriculum handbook which includes content mapping, and copies of course syllabi are available in the resource room (OSIII-1). In February of 2012, eight faculty attended an assessment workshop to determine strategies to measure the student learning outcomes. During this workshop, faculty realized that the newly revised student learning outcomes were multifactorial, and therefore, very difficult to adequately and accurately measure. Additionally, there were concerns about the understandability of the student learning outcomes to the college s communities of interest. At this same time, faculty recognized that the second paragraph of the

2 mission was redundant with the student learning outcomes. Therefore, faculty revised the mission and student learning outcomes to enhance clarity while maintaining congruency with The Essentials (ERIII-6). Appendix III-A.1 depicts the relationship between the mission, course objectives, student learning outcomes, and expected aggregate student outcomes. Plans are made to conduct an analysis of current course objectives in the spring of 2013 to assess alignment with the newly revised mission and student learning outcomes. Revisions to course objectives will be made as needed. Expected aggregate student outcomes are examined annually by the assessment committee, through collaboration with the UGCC and GCC, to determine achievement of the mission, course objectives, and student learning outcomes as reflected in Appendix III-A.1. Master s Program The master s program has undergone significant growth over the last few years and now offers six distinct tracks: AGNP, FNP, EPHL, NE, CNL, and RN-MSN. The AGNP track added in 2012 and the CNL and RN-MSN added in 2011 were in response to the needs of our community of interest. More information can be found in Standard II regarding these additions to the master s program. Curricula for the various tracks were developed, implemented, and revised to reflect clear statements of expected individual student learning outcomes that are congruent with the program s mission, and expected aggregate student outcomes. All curricula for these tracks are presented as designated by AACN: graduate nursing core (MSN core courses), direct care core (advanced practice nursing core courses) and the track specific (specialty courses). In response to the revised Essentials of Master s Education in Nursing (AACN, 2011) and the adoption of the revised mission in May 2012, the faculty revised the student learning outcomes (ERIII-7, ERIII-8). Expected aggregate student outcomes are examined annually to determine achievement of the mission, course objectives, and student learning outcomes. An analysis of current course objectives is occurring at the time of writing of this report to assess alignment with the mission and student learning outcomes (ERIII-9). Appendix III-A.2 provides a more detailed view of the relationship between the mission, student learning outcomes, course, selected course objectives, and expected aggregate student outcomes. Samples of syllabi and content mapping will be in the onsite resource room (OSIII-2). 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).

3 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. 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: Baccalaureate Program The undergraduate curriculum is developed, implemented, and systematically revised to ensure integration of relevant professional nursing standards and guidelines. As a result, these standards and guidelines are evident in the curriculum, individual student learning outcomes, and aggregate student outcomes. Faculty have identified the following standards for the baccalaureate program as a basis for preparing graduates for their professional roles: The Essentials of Baccalaureate Nursing Education for Professional Nursing Education (AACN, 2008) Quality and Safety Education for Nurses Competencies (QSEN) Guide to the Code of Ethics for Nurses (ANA, 2010) Nursing: Scope and Standards of Practice, 2 nd edition (ANA, 2010 Nursing s Social Policy Statement (ANA, 2010)

4 To ensure the curriculum is revised to meet the changes in professional standards, the UGCC bylaws state initiate, through recommendations to FGA, curricular modifications and innovations in response to professional and societal trends (ERIII-10). Through the CAP Section III.A, the UGCC discusses necessary revisions to address changes in standards and guidelines (ERIII-1). The integration of the Essentials (AACN, 2008) is an example of how this process is actualized, as discussed in Standard III-A above. Early discussions about the integration of the Essentials (AACN, 2008) can be found in the UGCC minutes (ERIII-11). While the Essentials (AACN, 2008) were the primary guide for recent revisions to the college mission, student learning outcomes, and course objectives, the QSEN competencies were also integrated to ensure our students develop the knowledge, skills and attitudes necessary to continuously improve the quality and safety of the healthcare systems. Through learning activities, the Essentials (AACN, 2008) and QSEN competencies are actualized through attainment of course objectives. In August of 2012, faculty were updated on QSEN competencies at the UGCC workshop (ERIII-12). All nursing courses have specific assignments focused on QSEN competencies. Appendix III-B.1 shows the alignment of the Essentials (AACN, 2008), QSEN competencies, selected course objectives and learning activities, student learning outcomes, and expected student aggregate outcomes. As professional resources to guide their nursing practice, students purchase the Guide to the Code of Ethics for Nurses, Nursing: Scope and Standards of Practice, and Nursing s Social Policy Statement upon entry into the nursing program. These ANA publications are introduced to students in an early course, NU 3100 Professional Concepts, with an activity in which students use these resources to determine practice guidelines for case studies. As students progress through the curriculum, these standards, for example professionalism and ethical behavior, are integrated into courses and student clinical evaluation rubrics (Appendix III-F.2). Master s Program Expected individual student learning outcomes are consistent with the roles for which the college 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, individual student learning outcomes and expected aggregate student outcomes. As noted in Appendix III-B.2, the master s curricula incorporate professional standards and guidelines which align with the student learning outcomes, course objectives/learning activities, and expected aggregate student outcomes. The master s program and all tracks are built upon The Essentials of Master s Education in Nursing (AACN, 2011). In addition, each track also uses standards, guidelines, and competencies to develop the role specific courses:

5 The Advanced Practice Nursing Core Curriculum Domains and Core Competencies of Nurse Practitioner Practice (NONPF, 2012) Adult-Gerontology Primary Care Nurse Practitioner Competencies (AACN/NONPF/Hartford, 2010) Family Nurse Practitioner Domains and Core Competencies (AACN/NONPF, 2002) Criteria for Evaluation of Nurse Practitioner Programs (NTF, 2012) The Clinical Nurse Leader Core Curriculum Working Statement Comparing the Clinical Nurse Leader and Clinical Nurse Specialist Roles: Similarities, Differences and Complementarities (AACN, 2004) White Paper on the Education and Role of the Clinical Nurse Leader (AACN, 2007) The Nurse Educator Core Curriculum Core Competencies for the Nurse Educator with Task Statements (NLN, 2005) The RN-MSN Baccalaureate Specialty Curriculum The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008) The Executive Practice and Health Leadership Curriculum (EPHL Scope and Standards for Nurse Administrators, 2 nd ed. (ANA, 2009) AONE Nurse Executive Competencies (AONE, 2005) As previously mentioned, The Essentials (AACN, 2011) was the primary guide for the revisions in the expected student learning outcomes of the master s program. The Essentials (AACN, 2011) also guided revisions the MSN in nursing core course descriptions and course objectives, all of which were approved by FGA in November of 2012 (ERIII-13). Currently, with the exception of the EPHL track, course descriptions and course objectives of the advanced practice nursing core and specialty course work are under revision using The Essentials (AACN, 2011) as a guide. In December of 2012, the FGA approved revisions of the EPHL track (ERIII-14). To ensure that the curriculum meets the changes in professional standards, graduate courses are reviewed in an annual graduate curriculum workshop, and courses revised as needed. Additionally, as new standards become available, faculty begin integration consideration (ERIII-15). For example, new graduate QSEN competencies were recently made available. Two faculty members are attending QSEN training in the spring of 2013 and will provide direction for integration of the competencies into the graduate curriculum. 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.

6 Elaboration: Baccalaureate program faculty and students articulate how knowledge from courses in the arts, sciences, and humanities is incorporated into nursing practice. Post-baccalaureate 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: Baccalaureate Program Built on a foundation of arts, sciences, and humanities, the baccalaureate curriculum is designed to foster the achievement of individual and aggregate student outcomes. In partnership with RU, the college offers a joint undergraduate degree in nursing through two options: the traditional baccalaureate degree and the accelerated baccalaureate degree. The traditional degree is for four year degree seeking students; RU provides the liberal education component and the college provides the nursing coursework. The accelerated degree is for students who have already earned a baccalaureate degree in another field and are returning to college to earn a degree in nursing. Traditional Option The entire curriculum is detailed in the RCN catalog. The RU liberal core curriculum includes required courses in seven classical modes of inquiry, three academic proficiencies, and one requirement in global perspectives. The classical modes of inquiry include art, history, literature, sciences (causal and relational), philosophy, and theology. These modes of inquiry encourage the full development of students in various aspects of their humanity and total 40 credit hours. The three proficiencies are oral communication, written communication and mathematics and total 12 hours. The global perspectives requirement is a three credit hour course with a global designation or two semesters of the same college level second language. Prerequisites for the courses that establish a foundation for the nursing major total 14 credit hours. The liberal education component totals 66 credit hours as shown in the curricular blueprint (ERIII-16). The liberal core curriculum provided by RU forms the basis for intellectual and practical abilities for nursing practice and encourages engagement with the community, locally and globally. The core

7 curriculum reflects the Jesuit ideal of a well-rounded education and the development of inquisitive, lifelong learners, all of which are congruent and support the mission of RCN. The liberal education component of the baccalaureate degree prepares students for the upper division nursing coursework and supports achievement of student outcomes (Appendix III-C.1). The liberal education courses develop and enhance communication skills, mathematical proficiency, and personal, social, cultural, ethical, moral, and civic values. Selected examples are as follows: History courses support nursing coursework assignments related to understanding and appreciation of the historical perspectives in nursing. Courses in communication and English promote effective written communication and oral communication for public speaking as well as interpersonal communication, critical for the professional nurse. Courses in psychology, sociology, and anthropology (science relational and global perspective focused) support nursing coursework focused on the care of a culturally diverse population. Math courses provide the foundation for ensuring safe administration of medications through accurate dosage calculations. In addition, math courses contribute to the ability of students to evaluate research to support evidence-based practice. Chemistry and anatomy/physiology courses are fundamental to understanding pathophysiology and promote recognition of alterations in health when caring for patients. Nursing courses continue the process of student development through classroom and clinical activities. Accelerated Option The AO is a second degree opportunity for individuals who have already earned a baccalaureate degree in another field. Students in this option are considered to have already met the general education requirements (liberal arts and sciences) through their prior degree. There are certain prerequisites necessary for the nursing major and credit evaluation of individual transcripts determines which of these have been met in the prior degree. The entire curriculum and list of pre-requisites are detailed in the RCN catalog. Master s Program The graduate curriculum, which is built on the foundation of baccalaureate nursing knowledge, is logically structured to achieve expected individual and aggregate student outcomes. Based on the Master s Essentials (AACN, 2011), the curriculum is presented as: graduate nursing core (MSN in nursing core courses), direct care core (advanced practice nursing core courses) and the track specific core (specialty courses). Appendix III-C.2 demonstrates how the graduate curricula build on the baccalaureate Essentials (AACN, 2008), and shows the relationship among the graduate nursing core and direct care core curriculum, functional area content (track specific), student learning outcomes, master s Essentials

8 (AACN, 2011), and aggregate outcomes. Appendix III-C.3 gives examples of the graduate nursing core and track specific courses. The entire syllabi, curriculum and a list of pre-requisites for each track can be found in the RCN catalog. Graduate Nursing Core The graduate nursing core includes five courses, totaling credit hours. These courses provide the foundational content essential for all graduate students and include: NU 6020 Theoretical Foundations of Nursing, NU 6060 Role Development in Advanced Nursing, NU 6080 Nursing Research, NU 6040 Contemporary Issues in Nursing and NU 7xxx Research Option. This core curriculum content provides knowledge based on the master s Essentials. For example, students in NU 6080 Nursing Research build upon knowledge from their BSN research courses through skill development in the critique process as well as through an evidence-based review of literature. Students identify significant evidence that is used to base recommendations for practice change. With these skills and knowledge, students will develop an innovation to change practice in the research utilization project course. Direct Care Core The master s program includes the recommended direct care core by the Master s Essentials (AACN, 2011). The direct care courses include: NU 7040 Advanced Pathophysiology, NU 7060 Advanced Health Assessment and NU 7080 Advanced Pharmacology. These courses support the specialty course work in the FNP, AGNP, CNL, and NE tracks. For example, NU 7060 Advanced Health Assessment offers students the theoretical and clinical base for comprehensive health assessment of individuals across the lifespan. This course builds upon the undergraduate health assessment course and is considered an essential prerequisite course for all FNP, AGNP, CNL, and NE students for subsequent practicum courses. RN-MSN Baccalaureate Specialty Courses The RN-MSN baccalaureate specialty courses are designed to assist students to achieve The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008). Included in these courses are didactic and practice experiences which transition a nursing student s role behaviors from the associate degree or diploma to the baccalaureate level of proficiency in order to prepare them with the necessary skills and knowledge for master s course work. The baccalaureate specialty courses include: NU 5020 Transitions in Nursing, NU 4212 Community Health Nursing, NU 4232 Community Health Nursing Practice and NU 4402 Capstone: Leadership in Professional Nursing Practice.

9 Students admitted to the RN-MSN track can choose the NE, EPHL, or CNL track. Students are given 35 hours of credit for their associate degree or diploma, according to their degree evaluation. Through the baccalaureate specialty courses, students acquire the knowledge and competencies comparable to baccalaureate nursing education as a foundation for the MSN coursework. The NU 5020 Transitions in Nursing course focuses on the baccalaureate Essentials (AACN, 2008) with an introduction to the Master s Essentials (AACN, 2011). The other baccalaureate specialty courses mirror the BSN course objectives and clinical requirements that build upon previous nursing experience of the RN-MSN student. Considering their previous experience, as well as completion of the baccalaureate specialty courses, students enroll in the graduate NU 6080 Nursing Research and NU 7060 Advanced Health Assessment in lieu of the baccalaureate courses. Track Specific Core In the track specific specialty courses the student applies knowledge gained from the baccalaureate curriculum as well as the graduate nursing and direct care core courses, or the RN to MSN baccalaureate specialty courses. Nurse Practitioner Tracks (FNP & AGNP) NP students integrate knowledge from the master s and direct nursing core into their track specific courses. For example, in the Primary Care Practicum courses, students utilize knowledge gained from NU 6020 Theoretical Foundations in Nursing, NU 6060 Role Development in Advanced Nursing, NU 6080 Nursing Research, NU 7040 Pathophysiology, NU 7060 Advanced Health Assessment, and NU 7080 Pharmacology to diagnose and treat patients in the clinical setting. NU 6040 Contemporary Issues in Nursing provides knowledge of finance models and health care reimbursement which are critical concepts for practice. FNP students focus on primacy care of individuals across the lifespan, while AGNP students focus on primary care of individuals age 13 and older. NU 7100 Primary Care I and NU 7110 Primary Care I Practicum are taken by both the FNP and the AGNP student. These courses focus on the primary care of individuals age 13 and older. FNP students also take NU 7020 Family and Community Concepts as well as NU 7141 Primary Care II Pediatrics. While, AGNP students take NU 7030 Gerontology for the Adult Geriatric Practitioner, current plans are underway to provide a didactic course in geriatrics that will provide the opportunity for deeper exploration of the application of the theoretical concepts utilized in NU 7030 Gerontology for the Adult Geriatric Practitioner. Executive Nurse Practice: Health Care Leadership Concepts learned in NU 6020 Theoretical Foundations of Nursing, such as chaos, complexity, and change, form a foundation for health care leadership courses. NU 6060 Role Development in Advanced Nursing prepares graduate students with the concepts necessary for effective socialization into the role of the executive nurse.

10 Nurse Educator Track In the NU 6040 Contemporary Issues in Nursing course, students examine concepts related to nursing education, such as the dedicated education unit and simulation that are more fully developed in the nursing education practicum courses. Students in NU 6020 Theoretical Foundations examine teachinglearning theory and multiple intelligence theory, which are crucial in the nursing education track. Clinical Nurse Leader Track Students utilize foundational information from the master s core courses, the advanced practice specialty core courses, as well as the role specialty courses. Students build upon the foundational concepts learned in NU 6080 Nursing Research and NU 6060 Role Development in Advanced Nursing such as, evidence based practice, evaluation of outcomes, quality improvement, and patient safety and apply them during their clinical residency. 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, distance education) support achievement of expected individual student learning outcomes identified in course, unit, and/or level objectives. Program Response: Baccalaureate Program Teaching-learning practices in the classroom and clinical settings promote student achievement of course objectives and individual student learning outcomes as well as expected aggregate outcomes. Teaching-learning practices Faculty continuously adapt their teaching strategies in an effort to more actively engage students in the classroom. These strategies include less traditional lecture with more active teaching-learning strategies, such as gaming, student group work, group presentations, role-playing, case study analyses, video, PowerPoint presentations, in class writing activities. The courses listed below illustrate specific strategies: NU 2030/31Foundations of Nursing Practice: a guest speaker shares the patient colostomy experience reinforcing the course objective related to patient centered care. NU 3200/01 and NU 3430/31 Adult Health Nursing I and II: provides a simulation experience to enhance the application of knowledge regarding effective, safe care of patients with musculoskeletal and pulmonary disorders. This strategy supports multiple course objectives, including communication, evidence based practice, professional nursing, and principles of health promotion and disease prevention.

11 NU 3210/11 Adult Health Nursing Practice I: student groups prepare a care plan and concept map using the classroom SMART Board technology. This strategy reinforces critical thinking and clinical reasoning to plan care. NU 3730/31 Maternal-Newborn Nursing theory course incorporates small group work for root cause analysis and just culture algorithms in discussion of high risk patient scenarios (ERIII-17). This strategy supports the course objectives of communication and delivery of care in complex health systems. NU 3570 Introduction to Nursing Research: students are actively involved in quality improvement projects with staff nurses through the collaborative partnership with RMC to address topics such as reducing readmissions, reducing restraint usage, and auditing DVT compliance. This strategy supports the course objective of utilization of the research process to support evidence based practice. Classrooms, lab space, and technology Through the CAP Section II.C, student satisfaction for classrooms, lab space, and technology are monitored (ERIII-18). After revisions to the classrooms and technology were made in 2010, student satisfaction scores on the EBI in this area increased. Classroom sizes vary from seats and can accommodate our cohort sizes. In 2010, new chairs and tables replaced desks with swing arms in two large classrooms (70 seats each), allowing students more space for their laptops. Many students utilize personal laptops for note taking and accessing information for discussion to supplement class activities, therefore, all classrooms are WIFI accessible. For presentations, all classrooms have a podium with a computer and a projector. SMART Board technology is available in five of the eight classrooms allowing for a variety of interactive activities that support critical thinking and clinical reasoning. Despite availability of this technology, use has been limited; faculty have indicated a lack of ease in using SMART Boards. Recently, new faculty participated in an educational session on this technology. Because of their positive response, plans are being made to offer this session to all faculty. Learning Resource Center The LRC provides opportunities for students to practice nursing skills and interact in simulated patient care scenarios. Students are able to apply knowledge from the classroom in a safe environment. For example, in the NU 3200/01 Adult Health Nursing I course, students rotate through multiple lab stations which require clinical reasoning to manage musculoskeletal patient scenarios. Faculty guide the simulation and provide formative evaluation. Another example of low fidelity simulation that occurs in the LRC is in the NU 2050/51 Nursing Assessment course. Students practice assessment skills on each other by taking a patient history and performing a physical assessment. Summative evaluation occurs during student performance of a head to toe examination on a classmate. Low-fidelity mannequins are available for simulation scenarios and invasive procedures.

12 Technology-enhanced delivery All nursing courses are Web-enhanced which allows students another avenue to ask questions, share ideas and thoughts, and access resources. Blackboard, which was initiated in fall 2012, is the organizational platform for courses. During the transition period to this new platform, the director of Web based education has provided ongoing support for faculty development. The Evolve Learning System was adopted by the college in the fall of This system allows students to have access to e-books, instructional videos, self quizzes, case studies, patient reviews, drug calculation tutorials and other learning activities. The Evolve Learning System enriches student learning by providing alternate methods to meet course objectives. HESI standardized testing and review is part of the Evolve Learning System and utilized throughout the curriculum. Simulation High fidelity simulation is a highly effective teaching-learning strategy for students. With the opening of the Seelos Center in the spring of 2013, opportunities for student participation in high fidelity simulation to measure competency in the application of knowledge and technical skills in complex scenarios will be available. The need for faculty development to effectively utilize simulation for teaching-learning has been identified. The director of the center, who has extensive training in simulation, will be instrumental in coordinating faculty development activities and collaborating with faculty to develop simulation opportunities across the curriculum. During spring 2013, an RCN master s student, completing her education practicum with the director of the simulation center, will assist in the development of policies and procedures for student and faculty use of the center. Clinical environment RCN has active contracts with over 340 clinical agencies in the greater Kansas City metropolitan and surrounding rural areas (OSIII-3). During the course of the undergraduate nursing curriculum, students spend over 750 hours in clinical settings providing direct patient care. Clinical group sizes are limited at 8 students to 1 faculty member to ensure adequate supervision as well as meet RCN and agency policies. Acute care hospitals, mainly within the HCA MidAmerica Division are the site for most adult health care clinical experiences. A large regional pediatric hospital provides clinical experiences in the care of children. Community sites such as elementary schools, junior and senior high schools, older adult centers, outpatient clinics, home health care agencies and public health centers provide experiences for students in the specialty clinical settings. See Appendix III-D.1 for a detailed list of clinical courses and their respective clinical agency sites. The experiences in the junior year focus on care of the adult in medical-surgical and mental health settings while the experiences in the senior year focus on specialties such as pediatrics, maternal-

13 newborn, and community health. In the initial nursing clinical courses, students care for one patient to acclimate to the clinical environment and develop organizational skills; this may increase to two to three patients for many students by the end of their clinical rotation. In these varied settings, students are exposed to many disciplines to value interprofessional communication and collaboration, develop information management skills as they utilize different electronic health records and resources, and increase their understanding of different complex health care systems. The culmination of the curriculum is the NU 4400/01 Capstone course, which is a seven week clinical immersion experience. During this time, students are transitioning from the role of student nurse to graduate nurse. Guided by their clinical preceptor, students become an active member of an interprofessional team and assume primary responsibility for providing and managing patient care. Although students are exposed to a diverse population in their clinical sites, the college reinforces the importance of cultural sensitivity by incorporating social justice experiences through four clinical practice courses (ERIII-19). The course objectives of social justice participation are met through clinical group activities. Activities are related to four designated domains of social justice: poverty, minority health, the medically underserved and environmental health, which is explored as students move through the four practice courses. As part of the social justice curricular plan, students participate in a college wide service project. The service project sites, Niles Home for Children, the Annual Community Block Party, and Operation Breakthrough, provide opportunities for students and faculty to be involved in educational activities that support the social justice curricular plan. In spring 2013, as a new teaching strategy, RCN formalized a partnership with the Intensive Care Unit at RMC as a clinical site to pilot a Dedicated Education Unit (DEU) (ERIII-20). This is the first DEU to open in the greater Kansas City metropolitan area. In this evidence-based teaching model, staff nurses, in collaboration with RCN clinical faculty, serve as clinical instructors for the students. RCN faculty developed and provided a day long workshop, DEU Clinical Instructor Training, for the ICU staff participating in the DEU. The DEU clinical instructors received education related to the RCN mission, course objectives and student learning outcomes. Opportunities to simulate teaching strategies in a variety of scenarios were included in the workshop. (ERIII-21). During the spring 2013, the DEU is providing clinical placement for 16 junior nursing students in their NU 3440 Adult Health Nursing Practice II course. Following an evaluation of this pilot program, establishing additional clinical units designated as DEUs will be considered. Master s Program Teaching-learning practices in both the classroom and clinical settings reflect unit and course objectives and support the student learning outcomes as well as aggregate outcomes. Faculty employ a variety of teaching-learning practices (Appendix III-D.2). All courses in the curriculum are Web-enhanced, providing

14 an online course platform using Blackboard, but the six tracks vary in the number of courses that are offered in a completely online format. For example, NU 7060 Advanced Health Assessment is the only core course offered as a hybrid class with in-class meetings every other week. These in-class meetings, held in the RCN classrooms, facilitate the intensive hands on learning required to master necessary skills and meet course objectives. For example, there are demonstrations of assessment techniques and evaluations of mastery of these skills at each class meeting. In addition, simulation experiences, such as suturing and live model exams are provided during this time. The NP specific courses NU 7100 Primary Care I, NU 7141 Primary Care II Pediatrics, and NU 7142 Primary Care Women s Health, meet in order to facilitate active participation and allow for immediate feedback to the student. For example, in NU 7100 Primary Care I, students actively participate in group simulation experiences utilizing evidenced based practice to solve unfolding case studies. The practicum courses, NU 7110 Primary Care I, NU 7174 Primary Care II Pediatrics, NU 7142 Primary Care II Women s Health and NU 7451/52 Independent Primary Care Practicum also meet periodically on ground. These class meetings allow for guest lectures on necessary topics and skills such as reading EKG s and x-rays as well as concepts for billing and coding. Class meetings were initiated based on student feedback. Faculty are experienced and creative in the online environment and students appreciate the flexibility it provides. In fall 2012, the college transitioned from WebCT8 to Blackboard. While faculty are still learning how to most effectively utilize this specific tool, administration has been supportive and provided multiple in-services to facilitate the transition. The director of technology is actively involved in the process and is readily available. Discussions and learning activities, which are vital in online courses, are conducted at a level that requires critical thinking, substantive contributions and peer review from students to meet student learning outcomes (OSIII-4). Faculty appreciate the new platform s ability to add grading rubrics in the discussion boards which allows immediate and consistent feedback to students. Rubrics can now be utilized to demonstrate how students are meeting the course objectives as well as student learning outcomes. Many other strategies are used to facilitate learning in the online and in-classroom environments; for example, case studies, evidenced based practice teaching projects, poster, group and PowerPoint presentations, demonstration-return demonstration, simulation, lab, guest lectures, and clinical experience. While faculty appreciate the flexibility of online courses, certain challenges exist in verifying attendance and test security. Blackboard provides a way to track students in the course for attendance, participation in discussion groups and materials that students access as well as how often they access those materials. Faculty have used face to face discussion through video chat and posting either a picture or vitae to facilitate the online community as well as verify student attendance. Testing is given online or in the classroom. Security is managed by using Respondus lockdown browser, delivering one question at a time, using test banks and/or randomizing tests. An area for improvement is the development of a

15 distance policy that will address attendance verification and potential security issues, ensuring the community of interest is served through a quality on-line education program. Clinical sites are selected to enhance the student s ability to meet course objectives. While students are expected to find their own clinical sites, a wide variety of sites exists in the greater Kansas City metropolitan area as well as surrounding rural areas. Appendix III-D.3 shows a sampling of current NP clinical sites. A complete listing of sites is available on-site (OSIII-5). For example, students in the AGNP program find clinical sites in internal medicine that incorporate hospital care, hospice care and/or nursing home care, while FNP students find clinical sites in family practice in both urban and/or rural areas. According to exit results, students are very satisfied with the quality of these sites. Clinical sites offer students opportunities to participate in utilization of informatics and healthcare technologies and demonstrate inter-professional collaboration. Furthermore, students apply the principles of clinical prevention and population care. Students participation in discussions facilitates achievement of course objectives and are used to augment clinical time by requiring critical thinking and substantive contributions. Examples of discussion topics include the application of quality improvement methods within an organization and utilization of the policy development process. Clinical site information and affiliation agreements are available onsite in the resource room (OSIII-6). Students report that clinical sites are adequate; however it is likely that at some point in the practicum year, students may encounter some difficulty obtaining a clinical site for several reasons. First, there is competition for clinical site placement between other NP programs and medical schools in the Kansas City. Second, many sites, due to the implementation of electronic health records, are not taking students. Third, RCN numbers continue to grow and more sites are necessary. NP faculty have identified this as a need and are actively seeking solutions. NP faculty coach students in the identification of clinical sites and guide them in procuring a site when necessary. In addition, NP faculty have actively increased the pool of preceptors by encouraging our experienced graduates to precept new students and acknowledging consistent preceptors as affiliate faculty with continuing education benefits Classroom and clinical lab spaces are adequate to allow students to meet the course objectives. Most of the graduate course work is done online; however, the few courses that do meet on ground have adequate space. The LRC provides the equipment and physical space that graduate students need to practice with equipment used in clinical settings, for example, microscopes, and otoscopes. The addition of the Seelos Center provides two exam rooms for graduate simulation experiences that mirror clinical experiences. Graduate students use classroom N, the auditorium, and LRC and computer labs at the hospital as well as room 310 at the college. The actual number of seats and detailed discussion of available space occurs in Standard II.

16 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 program-identified community of interest (e.g., use of distance technology, simulation, adult learner needs, second language students). Program Response: The curriculum and teaching-learning practices of the college consider the needs and expectations of its community of interest. The college describes its community of interest as the internal (college administration, faculty, and students) and the external (employers, nurses in the region and across the HCA MidAmerica Division health system, alumni, clients, specialty groups such as the local Nurse Executives). Expectations and needs of the community of interest are gleaned through the student and graduate surveys, employer surveys, periodic focus group sessions with students, and nurse executives from around the community. Needs of the surrounding community are periodically assessed and considered in curricular changes. For example, as a result of these assessments in 2009, the CNL and RN-MSN tracks were developed. Standard I-B provides more information on these assessments. Baccalaureate Program Teaching-learning practices are appropriate to the needs of the student population and build on prior learning. Faculty adapt teaching-learning strategies based on differences between students in the TO program and those in the AO program. Recent high school graduates comprise a majority of TO students; others are transfer students, or adults entering college for the first time or who are changing careers. AO students have completed an undergraduate degree in a field other than nursing and thus may bring diverse background career experiences to the classroom. Generational differences are recognized in respect to technology needs. Assistance is provided for students with limited computer technology skills by the director of technological resources and by the director of Web-based education. For the nontraditional and accelerated students, faculty plan discussions and activities that build upon their past life experiences. The option of using online activities is important for this group of students due to family and multiple outside of the classroom commitments. Classroom discussion is utilized with TO students by linking previously learned concepts to current content. Students who identify themselves as second language learners often find learning medical terminology challenging. Non-native speakers must learn this new terminology and be able to translate between their native language and English. This difficulty is most often reflected in a testing environment. Faculty recognize that second language learners may need assistance with language barriers in order to succeed in the nursing curriculum. Referrals to the RU Counseling Center are made to support test taking

17 strategies. Students are encouraged to meet with the college learning center tutors for additional help with medical terminology. To meet the needs of nursing students, NU 3852 Global Perspectives in Public Health was developed as a nursing elective in response to the addition of a global perspectives requirement to the liberal core curriculum at RU (ERIII-22). This course provides flexibility as an online option for nursing students to meet the RU global perspectives requirement within their nursing coursework. In response to lower NCLEX-RN scores and employer feedback, faculty recognized the need for a course focused on strategies for successful entrance into the profession. A credit hour change in the senior year of the nursing curriculum provided for the opportunity to develop the course, NU 3790/91 Professional Development Strategies. Topics such as nursing resume preparation, interview techniques, portfolio development and tactics for success on NCLEX-RN are included. Content may change based on assessment of individual class needs. Master s Program The curriculum and teaching-learning practices meet the needs and expectations of graduate students. The decision to offer all core courses, two of the advanced practice nursing core courses, and one entire track (EPHL) in an online format was made in response to the needs of MSN students who desire flexibility in their educational options. One advanced practice course, NU 7060 Advanced Health Assessment and all of the FNP/AGNP specialty core didactic as well as two clinical courses: NU 7100 Primary Care I, NU 7141 Primary Care II Pediatrics, NU 7142 Primary Care II Women s Health, NU 7451/52 Independent Primary Care Practicum for the FNP and AGNP, meet on ground to help students master the high level learning required and achieve student learning outcomes. Feedback from distance students indicates that the college provides a very user-friendly environment and promotes their ability to maintain the balance between work and school. Four post-master's certificate programs were developed in anticipation of requests from nurses who may want to acquire knowledge and skills in the EPHL, NE, FNP, or AGNP tracks. In response to a need s survey of our community of interest, the RN-MSN track was developed to meet the needs of the associate degree and diploma nurses who desire an advanced degree. Teaching-learning practices are appropriate to the needs of the student population and build on prior learning. Since students come from a wide variety of clinical and life experience, faculty adapt teachinglearning strategies based on adult learning theory. For example, some graduate students are new nurses who may be learning a new career while going to school while others may have twenty-five years experience as a registered nurse. In addition, there may be a wide range of technology skills based on

18 previous work and life experiences. Faculty assist students to find the appropriate resources to facilitate learning, for example, the RU helpdesk. Students who identify themselves as second language learners typically struggle somewhat with both conversational writing and scientific writing. Faculty recognize that second language learners may need assistance with language barriers in order to succeed in the nursing curriculum. Referrals to the RU learning center are made to support writing needs. Currently in the NP programs, on ground simulation is used in suturing, active demonstration of history taking and physical exam skills, final exams using case study scenarios, practice on low fidelity models and live models. Historically and nationwide, high fidelity simulation has been limited at the graduate level. In anticipation of the addition of the Seelos Center, one NP faculty member has attended the HITS (Health Information Technology Scholars) program in order to share with colleagues how to implement high fidelity simulation across the graduate curricula. 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: Baccalaureate Program Grading criteria are defined and communicated to students in the RCN catalog (ERIII-23) and also in the syllabus of each nursing course. All didactic courses use the same grading scale criteria. Students must achieve a minimum grade of C in all NU courses. Faculty use a variety of methods to evaluate students, including exams, written papers, group projects, and oral presentations. Appendix III-F.1 shows a sampling of methods that courses use to measure individual student learning outcomes. Faculty in all clinical courses utilize a formative evaluation scale of satisfactory, needs improvement and unsatisfactory. Students are introduced to the rubric scale criteria during course orientation. Evaluation is based on grading rubrics reflecting course objectives, as well as weekly discussion postings and student selfevaluation through reflection. Summative evaluation of clinical practice is graded by faculty as either

19 satisfactory or unsatisfactory. Students must achieve a satisfactory final evaluation in all nursing clinical courses. A sample rubric from NU 3440/41 Adult Health Practice II can be found in Appendix III-F.2. Faculty communicate evaluation of student clinical progress on both a one to one basis during clinical practice and via Blackboard. In courses using preceptors, such as in the NU 4400/01 Capstone course, faculty communicate on a weekly basis with preceptors to discuss student performance. Although preceptors utilize the same grading rubric as course faculty to provide feedback on student performance, faculty are ultimately responsible for completing the final evaluation of students. As courses have developed their own clinical grading rubrics, variations in format and application were noted by the UGCC. The need for consistency in use and form of rubrics across courses is identified as an area for improvement. A task force of the UGCC has begun initial review of all clinical course rubrics (OSIII-7). Master s Program The grading scale for the master s program differs from that of the baccalaureate and can be found in the RCN catalog (ERIII-24). Grading criteria are found in each course syllabus. A variety of methods are utilized to evaluate students. Examples in didactic courses include discussions, quizzes, exams, papers, and projects. In clinical courses, faculty use weekly discussion postings and face to face meetings with students as well as individual clinical visits by faculty and consultation with preceptor. Although students in each track arrange for their own preceptors, sites and preceptors are monitored by faculty to ensure that preceptors are qualified to assist students in developing the knowledge and skills in the respective track. Faculty and preceptors evaluate student clinical performance using a clinical evaluation tool developed by faculty members in each track (OSIII-8). The faculty are responsible for awarding the final grade for student performance. Two of the RN-MSN baccalaureate specialty courses include clinical experiences in NU 4232 Community Health Nursing course and in the NU 4402 Capstone course. The RN-MSN students will explore clinical areas of interest with faculty approval and guidance to fulfill the clinical requirements for those courses. Faculty will maintain contact with preceptors and students on a weekly basis. Student learning in each of the practica and in the RN-MSN clinical courses is evaluated using the course objectives. This evaluation incorporates the student's self- assessment, a preceptor assessment of student performance, and final evaluation by the faculty.

20 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: Data from faculty and student evaluation of teaching-learning practices are utilized to inform decisions to facilitate achievement of individual student learning outcomes. Evaluation of the curriculum and teachinglearning practices is an ongoing process at the program, curricular, and course level. Formal processes for evaluation of the curriculum and teaching-learning are identified in the CAP Section, III.B (ERIII-25) as well as the assessment section of the faculty handbook (ERIII-26). Both the assessment and curriculum committees have responsibility for monitoring teaching-learning practices and student learning outcomes at the program and curricular levels. Faculty are responsible for implementation of the curriculum as well as assessment of teaching-learning practices and achievement of student learning outcomes at the course level. Students have the opportunity to provide feedback on teaching-learning practices and learning outcomes through completion of course and faculty evaluations. Also, students have input as members of the curriculum and assessment committees. Students are consistently encouraged to evaluate faculty and courses through course reminders. However, in the last two years, it has been challenging to obtain a significant number of respondents for these evaluations due to the need to use a separate online program for the surveys. With the adoption of Blackboard in fall 2012, students can now access surveys through the same program. Response rate is currently being assessed. Student evaluations of faculty are shared with the faculty member and the dean for the purpose of assessing teaching-learning practices and needs for individual faculty development (ERIII-27). Faculty address student concerns in the annual review process with the dean and discuss goals for the next academic year (ERIII-28). Course evaluations are reviewed by course coordinators and results are shared through a meeting with course faculty (ERIII-29). Student feedback is reviewed for areas of strengths and weaknesses as well as suggested areas for improvement. The course coordinator reports the areas of strengths and weaknesses as well as plans for improvement in the annual course review. Any significant changes planned in content or teaching-learning practices as a result of this review are reported and shared in annually scheduled undergraduate and graduate curriculum workshops. The annual course review form has recently been revised to be more concise and user-friendly and is currently being piloted (ERIII-30).