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Pursuing 80/20 with the California Collaborative Model for Nursing Education (CCMNE) Taking the Long View: Visions of the Future Indianapolis, IN, June 28, 2012 California Institute for Nursing & Health Care Presenters: Deloras Jones, MS, RN Executive Director, CINHC Liz Close, PhD, RN Nursing Education Consultant, CINHC Snapshot CA Nursing Education 2010/2011 Completions from schools of nursing, state-wide: AD 62% BSN 31.2% ELM 6.7% Regional differences in ratio of AD/BSN+ new grads range from: low of 44% & 47% AD in San Diego & SFBA high of 79 & 81% in So. CA & Central Valley 2010 Distribution of nursing workforce by highest level of education Diploma 8.4% AD 38.5% BSN 41.7% MSN/Doc. 11.5% 2010 only 20.8% AD went on to obtain a BSN+ 2011 Nursing Programs in CA 145; 74% public, 26% private AD 89 (inc LVN to AD) BSN 39 ELM - 17 Traditional Articulation Degree Program BSN Post Licensure Programs ADN MSN Diversity Technical Assistance (2011) [KPSC] AB 1295 Removal of Duplicate Courses (2009) BSN at Community Colleges (2008/10) (AB 2400) SB 1440 Transfer Model Curriculum (2010) NEW STATEWIDE MODEL OF NURSING EDUCATION New Practice Model CCMNE (2008) [KPNC, FCCC, CCCC, CWI, SB Program] Sacramento Model (2002) White Paper on Nursing Education Redesign (2007/08) [GBMF] IOM Report Recommendation #4 Health Care Reform OCNE (2006) 1

CCMNE Required Elements DUAL ADMISSION Current ADN student is admitted to, and sequentially or simultaneously enrolled in, Post-Licensure BSN ( RN-BSN ) program. INTEGRATED CURRICULUM Nursing, prerequisite and general education coursework and degree requirements are coordinated between the ADN and BSN degree programs without inadvertent duplication or repetition. SHARED FACULTY Qualified community college and university faculty collaborate on nursing curriculum development, delivery and evaluation. BSN ATTAINABLE IN ONE YEAR BSN is achievable within one calendar year after completion of the ADN. PERMANENCE and SUSTAINABILITY All elements of the CCMNE are institutionalized at collaborating community college and university to insure continuing program viability. Research Activities Survey 44 responses received representing 37 CSUs and CCCs. 100% of the CSUs and CCCs surveyed responded Interviews 20 program directors were invited to participate in a phone interview 19 (95%) agreed to be interviewed 5 Assessment Participants CCMNE implementation phase 6 12 CCMNE developmental phase Service Areas: Channel Islands, Chico, Dominguez Hills, East Bay, Fresno/Stanislaus, Monterey, Northridge, Sacramento, San Diego, San Francisco, San Jose, San Marcos, Sonoma Included: 12 CSUs and 25 CCs 6 2

Current vs Target Rate for Continuation 7 Progress by CCMNE Core Component Admission Permanence & Integrated Curriculum BSN in 1 Year Shared Faculty 8 Admission Different Approaches admission some BSN coursework first, then all ADN, then BSN completion enrollment during CSU summer sessions for ADN students enrollment last semester of ADN all ADN coursework, one BSN class 9 3

Progress by CCMNE Core Component Admission Permanence & Integrated Curriculum BSN in 1 Year Shared Faculty 10 Integrated Curriculum Different Approaches CCs and CSUs develop curriculum roadmap Programs incorporate QSEN CCs and CSUs collaborate to align content and coursework CSU makes changes to avoid duplication Programs take action to create expectation of continued academic progression Progress by CCMNE Core Component Admission Permanence & Integrated Curriculum BSN in 1 Year Shared Faculty 12 4

Shared Faculty Different Approaches & Questions Some progress reported by interviewees, many questions/challenges Different salary structures CSU/CC Different unions CC faculty teaching in CSU No CSU teaching in CC CC faculty teach in dual enrollment summer session CCMNE professional development activities for all faculty Regularly scheduled meetings between program directors 13 Progress by CCMNE Core Component Admission Permanence & Integrated Curriculum BSN in 1 Year Shared Faculty 14 BSN in One Year Progress & Questions: Can it be done? Credit for prior learning Best way to use the summers? Agreement on General Education Requirements 15 5

Progress by CCMNE Core Component admission Permanence & sustainability Integrated curriculum BSN in 1 year Shared faculty 16 CCMNE Core Components Permanence & sustainability admission? Integrated curriculum Survey & Interview Finding: Need to clarify definitions of each core component and different approaches available to achieve progress in implementation BSN in 1 year Shared faculty 17 DRIVERS WHICH FACTORS SUPPORT AND LIMIT IMPLEMENTATION OF THE CCMNE? 18 6

Factors Supporting CCMNE Implementation (interviews) Respect and Trust Respectful, trusting relationships between all of the school partners Public recognition of value and professional quality of programs offered by each school partner 19 Factors Supporting CCMNE Implementation (interviews) CCMNE professional development and planning activities including faculty from all participating institutions; extended to include adjunct faculty Strong relationships, regular conversations between CCMNE program directors Recognition of importance of including CCC Education Counselors in CCMNE professional development and planning activities Participation of employer partners, especially in curriculum integration and QSEN Outreach to students contributing to changing mindsets 20 Factors Supporting CCMNE Implementation (interviews) Extended education option (self-support model) Scholarships/internships Resolving financial aid challenges limiting dual enrollment Designated CCMNE Coordinator position 21 7

Factors Supporting CCMNE Implementation (survey) Theme: Key requirement is support from nursing administrators and faculty 22 Factors Limiting CCMNE Progress (interviews) Relationship development Lack of dedicated coordinator New information and ongoing change (new initiatives, e.g., AB1295, SB1440) 23 Factors Limiting CCMNE Progress (interviews) Concern about CSUs capacity to sustain current/support additional enrollment Challenge ensuring that funds go into nursing program to cover or sustain program cost when using extended education (self-support) option Overextended faculty, leaders multi-tasking as coordination of CCMNE added to responsibilities Sticker shock and affordability for students 24 8

Factors Limiting CCMNE Implementation Theme: Lack of affordability can be a major obstacle 25 Moving the field forward WHICH ARE PRIORITIES FOR TECHNICAL ASSISTANCE? 26 Technical Assistance Priorities 27 9

Technical Assistance Priorities Curriculum Integration Reaching agreement on GE requirements (63% identify as critically important) Identifying gaps and overlaps between CCC and CSU GE requirements (53%) Practical and/or financial details of dual enrollment (55%) Identifying and developing fiscal approaches to CCMNE (58%) 28 State of Implementation: 29 Technical Assistance Priorities (interviews) Strategies for making the BSN affordable to students Outreach and recruitment (including use of social media) Develop and promote financial aid package that can be used both at CSU and CCs Curriculum integration Supporting participation of under-represented students Update on effective practices, including Oregon Model 30 10

Emerging & Effective Practices (continued) CSUMB approach: AD content nested in BSN content CSUMB use of technology (e.g., e-portfolio and blog-supported class discussion) Joint professional development days each semester to build strong relationships (SFSU) Participation in other segment s advisory boards (SSU) Trust that partner institutions are equally capable of teaching students so that content can be divided between partners with confidence.(scc and CSU Sacramento) Engage employers in curriculum review/alignment process 31 Emerging & Effective Practices (continued) Development of curricular roadmaps (SFSU, Chabot) Inclusion of counseling department in development curricular map (CSUSM) Outreach to and sharing of curricular map with counselors (CSUCI) Outreach sessions to ADN students by CSU nursing directors and faculty (SFSU and SSU). They get up close and personal about applying. It is most helpful and well received by students. CSUCI Med Surg course-taking pattern (complete at CC, delayed awarding of units) COC vigorously follows up with students to make sure they meet key administrative deadlines. 32 11

Use of Findings to Provide Technical Assistance 12