Collegiate Nursing Education Research Articles

Empowering nursing students through inclusivity training for LGBTQIA+ patients: A quasi-experimental study

BackgroundThe current state of nursing education is concerning, with nearly two-thirds of the American Association of Colleges of Nursing (AACN) and Commission of Collegiate Nursing Education (CCNE) -accredited universities reporting that their nursing graduates are ill-prepared to care for the LGBTQIA+ community (Eickhoff, 2021). This lack of training is alarming, given the ongoing reports of LGBTQIA+ healthcare discrimination and the insufficient knowledge of nursing faculty to guide future nurses in caring for this patient population (Hughes et al., 2022). AimOur study sought to address this gap by developing and assessing the effectiveness of an LGBTQIA+ inclusivity training module for Baccalaureate nursing students. DesignWe employed a quasi-experimental pretest-posttest design, evaluating nursing students' knowledge and attitudes before and after the LGBTQIA+ inclusivity training. SettingThe study was conducted in a four-year baccalaureate nursing program in the Southern United States. ParticipantsJunior-level baccalaureate nursing students. MethodsUsing a pre-test post-test method, we collected data that included the Gay Affirmative Practice Scale, an LGBTQIA+ knowledge assessment, and a computer-based LGBTQIA+ inclusivity training module. ResultsN = 30 students consented and completed all necessary study components. The findings revealed significant improvements in pre-test and post-test GAP and knowledge assessment scores following the LGBTQIA+ Inclusivity Training for baccalaureate nursing students. ConclusionsThe results of our study underscore the effectiveness of an LGBTQIA+ computer-based simulation experience for baccalaureate nursing students, marking a significant step towards improving LGBTQIA+ healthcare inclusivity in nursing education.

Advanced practice nurse pharmacogenomics capacity and utilization.

Guided by Clinical Pharmacogenomic Implementation Consortium (CPIC) guidelines for >140 medications, pharmacogenomic tests inform medication selection and dosing to optimize efficacy while minimizing toxicities. This study assessed pharmacogenomic self-reported curricular content, knowledge, skills, attitudes, and usage in advanced practice registered nurses (APRNs) with prescriptive privileges. An online survey was administered assessing pharmacogenomic curricular content, knowledge, skills, attitudes, and usage. Data from 266 APRNs were analyzed. Most graduated with their highest nursing degree ∼10 years ago and reported pharmacogenomic curricular content ( n = 124, 48%). Pharmacogenomic curricular content was associated with pharmacogenomic familiarity ( p = .045) but not with knowledge confidence ( p = .615). Pharmacogenomic usage, defined as ordering a pharmacogenomic test within the past year, was low ( n = 76, 29%) and most ( n = 210, 84%) reported never using CPIC Guidelines. Advanced practice registered nurses ( n = 162) who did not anticipate ordering a pharmacogenomic test in the next year ( n = 77, 48%) indicated that they did not know what test to order. Deficits were identified in APRN pharmacogenomic knowledge and skills despite academic training. Most reported not ordering pharmacogenomic tests, did not know what test to order, and did not use CPIC guidelines. Pharmacogenomics is a quality and safety issue. Academic training did not result in practice integration and most reported capacity deficits. Recommendation for overcoming academic deficits include: (1) assessment of pharmacogenomics curricular content and faculty teaching capacity; (2) training addressing identified deficiencies; and (3) Commission of Collegiate Nursing Education policies that include pharmacogenomics in advanced pharmacology. Practicing APRN plans include on-the-job training and/or mandatory training at the time of relicensure.

Commission on collegiate nursing education standards inspire a new model of shared governance

PurposeA school of nursing re-envisioned its faculty organization structure and created a Shared Governance model based on the Commission on Collegiate Nursing Education Standards (CCNE). The model promotes shared decision-making and encourages nursing faculty and staff to exercise greater control over their professional endeavors. Principal resultsThe Shared Governance model launched as a one semester pilot before it was formally adopted by faculty. Faculty and staff are organized into four councils, each one representing the CCNE standards: Governance, Institutional Resources, Curriculum, and Quality. The Academic Leadership Team meets regularly with Shared Governance Council Chairs to foster communication and ensure a cohesive, proactive approach to conducting school of nursing business. Major conclusionsThe Shared Governance model has provided an excellent mechanism for new school of nursing faculty and staff to become oriented to their roles and the culture of academia. It has broken down silos and increased connections across programs and campuses. Ongoing conversations about the priority work of the school of nursing and each council's coordinated effort to document fulfillment of the Standards gave structure to preparation for our accreditation visit. The accreditation process is no longer seen as the sole responsibility of the Dean and Associate Deans.

Curriculum Mapping Post-Baccalaureate Registered Nurse Residency Curriculum to Accrediting Agency Standards.

This article examines the process of mapping a post-baccalaureate registered nurse residency curriculum with Commission on Collegiate Nursing Education standards for nurse residencies. Curriculum mapping revealed gaps and redundancies in the curriculum as well as documented compliance with accreditation standards. Curriculum mapping is instrumental to developing, evaluating, and refining curricular elements. Mapping curriculum with accreditation standards simultaneously fulfills accreditation requirements and can increase confidence in readiness within organizations undergoing accreditation site visits.

Overview of the Revised Commission on Collegiate Nursing Education Entry-to-Practice Nurse Residency Program Accreditation Standards.

Overview of the Revised Commission on Collegiate Nursing Education Entry-to-Practice Nurse Residency Program Accreditation Standards.

Nurse Educator Perceptions of Workplace Collegiality.

The nursing faculty shortage challenges nursing educators, administrators, and staff to find innovative ways to understand and address faculty retention. The purpose of this study was to examine nurse educators' perceptions of workplace collegiality and the possible correlation to role satisfaction and role persistence. Participants (n = 177) were recruited nationally from a Commission on Collegiate Nursing Education accredited schools listing. Three survey instruments were utilized: Survey of Collegial Communication, Job Satisfaction Survey, and Michigan Organizational Assessment Questionnaire. The study found a positive relationship between collegiality and job satisfaction in academia. The Pearson correlation results indicated there was a significant negative correlation between the intent to remain and collegiality. The findings suggest nursing educators perceive collegiality as an important component of job satisfaction and intent to remain.

Evaluation and quality improvement of Doctor of Nursing Practice-Family Nurse Practitioner scholarly projects.

The Commission on Collegiate Nursing Education's accreditation standards require nursing programs to demonstrate that students acquire doctoral-level knowledge and competencies beyond that expected at the baccalaureate and/or masters levels. The purpose of this article was to describe a quality improvement (QI) project for Doctor of Nursing Practice-Family Nurse Practitioner (NP) scholarly projects. Nurse practitioner faculty inquired about whether students' scholarly projects were of the quality and rigor expected at the doctoral, rather than masters, level. This project was conducted as a QI initiative and was designated as such by the institutional review board. Methods were based on Deming Plan-Do-Study-Act QI process model. Two doctorally prepared nursing faculty evaluated nine doctoral scholarly projects using the Roush DNP-PCAT instrument. This instrument evaluates 16 components, and key elements within each component, for completeness. The DNP-PCAT tool was evaluated for interrater reliability and content validity in an earlier study. Strengths and weaknesses were identified using quantitative and qualitative data analyses. Floor effects were seen in strategic planning, ethical concerns, data collection, results, discussion, and limitations. Qualitative findings identified weaknesses across all 16 components. Findings were similar to the results reported in a prior study. Results were reviewed and action plans were developed to improve the rigor of scholarly projects. The nursing faculty plan to incorporate routine evaluation of scholarly projects into their program evaluation. Other NP programs may benefit from instituting a similar process.

Teaching Innovations Using Systems Thinking to Guide Fieldwork Projects in RN-to-BSN Education

Background: A critical need exists to improve quality and safety within RN-to-BSN education through innovative teaching strategies. RN-to-BSN students are poised to improve patient outcomes through system-level awareness by use of scholarly fieldwork projects within practice settings. The purpose of this scholarship of teaching project was to use an adapted version of the Systems Awareness Model to develop and categorize RN-to-BSN students’ learning experiences and capstone-type fieldwork projects guided by systems thinking. Faculty members of the Catalysts for Change Community led this project. Methods: A modified Delphi technique using multiple iterations to reach consensus by faculty experts was used in the design of this scholarship of teaching project. The philosophical underpinning guiding this project was collaborative scholarship. The seven steps of the System Awareness Model adapted for leadership and management were used to guide faculty championing quality and safety of innovative teaching strategies in face-to-face, hybrid, or online teaching-learning environments. Results: Faculty described examples of evidence-based practice (EBP), change, and practice projects including ideas, titles, and descriptions in alignment with Quality and Safety Education for Nurses (QSEN) competencies and with newly adopted American Association of Colleges of Nursing Education Essentials. A grading rubric is provided for evaluating fieldwork student project outcomes. Conclusions: The teaching strategies and fieldwork projects described in this paper reinforce the American Association of Colleges of Nursing (AACN) RN-to-BSN White Paper and the Commission on Collegiate Nursing Education (CCNE) Teaching Standards. Suggestions for future research are offered.

Nursing Knowledge in the Doctor of Nursing Practice Curriculum.

The goal of Doctor of Nursing Practice (DNP) education is to prepare advanced practice nurse leaders for the practice setting. Accordingly, it is imperative that DNP education is grounded in nursing theoretical knowledge. The purpose of this project was to examine the presence of nursing theoretical knowledge within DNP programs across the United States. A retrospective approach was used to review publicly available information on the webpages of a sample of DNP programs accredited by the Commission on Collegiate Nursing Education (CCNE) to determine if nursing theoretical knowledge guided DNP programs. Demographic information was also collected. A sample of 100 CCNE accredited programs revealed a lack of nursing theoretical knowledge visible within DNP programs. It is unclear how DNPs are being prepared to be practice leaders guided by nursing theoretical knowledge. Nursing leaders must develop policies to assure that nursing knowledge is core in DNP programs.

Navigating public health clinical placements for rural online RN-BSN students

Purpose: In rural settings scare public health resources potentially limits the opportunities for nursing students living in these areas to participate in traditional one to one precepted experiences with public health agencies. To meet the revised Commission on Collegiate Nursing Education Standards related to direct clinical practice, creative strategies are needed for online degree seeking RN-BSN students who live in rural areas. This article explores an alternative learning experience by partnering students with a nonprofit healthcare institute to work on state health initiatives in the geographic region where the students reside.
 Process: In the absence of adequate opportunities for one to one precepted clinical experiences, student living in rural areas completing an online RN-BS program were partnered with a non-profit health organization. The students participate in an experiential learning experience to fulfill clinical hours in a public health setting as required by the Commission on Collegiate Nursing Education. In this case a cohort of students worked with a nonprofit healthcare institute on New York State’s T-21 campaign to further advance their knowledge on health initiatives driven by state health reform policy and actively participate community-based education.
 Conclusion: With a growing focus on population-based care and caring for vulnerable populations, particularly in rural areas, seeking clinical activities through partnerships with non-profit healthcare institute to improve health outcomes at the community level offers an alternative approach to engaging online degree seeking RN-BSN students in experiential clinical learning in communities with limited public health agency placements.
 Keywords: interprofessional learning, nursing accreditation, rural nursing students, service-learning pedagogy
 DOI: https://doi.org/10.14574/ojrnhc.v21i1.664

Differences in perceived marginalization in doctorally prepared nursing faculty.

Debate regarding the role of Doctor of Nursing Practice-prepared faculty in academic settings continues. Perceived barriers to successful integration include a lack of respect, inadequate infrastructure, and insufficient resources. The purpose of this study was to compare differences in self-reported marginalization in doctorally prepared (Doctor of Philosophy/Doctor of Nursing Practice) nursing faculty working in academic settings. A descriptive cross-sectional design was implemented to compare differences in self-reported marginalization between doctorally prepared faculty teaching in Commission on Collegiate Nursing Education accredited colleges. Marginality was measured using the Englund Marginality Index. Results of an independent-samples t-test indicate that Doctor of Nursing Practice -prepared faculty self-reported higher levels of marginalization (M = 41.7, SD = 9.6) than Doctor of Philosophy -prepared faculty (M = 39.1, SD = 10.5); t(583) = 2.8, p = .006. Strategies to decrease marginalization include improving systemic issues surrounding shared governance and outdated tenure systems as well as enhancing infrastructures that improve collaboration among doctorally prepared faculty.

Implementing a QAPI framework for improvement in an academic setting: A roadmap to success.

Designation as an accredited school of nursing (SON) requires "…. a comprehensive framework for ensuring quality in nursing education programs" (NLN CNEA, 2016). Although standards for accreditation of baccalaureate and graduate nursing programs are defined by agencies such as the Commission on Collegiate Nursing Education (CCNE, 2018) and the National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA) (NLN CNEA, 2016), methods for collecting, analyzing, or reporting data are not prescribed, resulting in wide variation in quality management processes among schools. The lack of a standardized approach can lead to inefficiencies, invalid or misleading data, and unnecessary stress for all involved in the quality management process (Hanna, Duvall, Turpin, Pendleton-Romig, & Parker, 2016). In contrast, hospitals and nursing homes frequently implement a quality assurance and performance improvement (QAPI) program, a well-defined, methodical approach to quality management. The QAPI model offers healthcare organizations a systematic, comprehensive, and data-driven strategy for maximizing outcomes (Centers for Medicare & Medicaid Services (CMS), 2016). Recognizing the need to improve and standardize the processes for data collection, analysis, and reporting, this paper describes how leaders at one accredited SON collaborated to translate CMS's QAPI model into the academic setting, establishing the foundation and mechanism to ensure the quality and integrity of the SON's outcomes.

A Nursing Leadership Practicum in the Time of COVID19:: A Southeastern University Experience

Coronavirus disease 2019 (COVID19) shutdowns have impacted nursing education, particularly student clinical experiences. In this paper, we discuss how we adapted an accelerated MSN nursing administration clinical course to meet the needs of our practicing students and the Commission on Collegiate Nursing Education (CCNE) standards in the context of the COVID19 pandemic. Resources available through the American Organization for Nursing Leadership (AONL) were utilized. Students reported a supportive, valuable learning experience they could apply in their future practice as nurse leaders. Considerations for future revisions to the course and to the AONL Guiding Principles are also presented.

Should Nursing Programs at Schools That Prohibit Same-sex Marriage be Accredited?

Should Nursing Programs at Schools That Prohibit Same-sex Marriage be Accredited?

Longitudinal study of a compassion fatigue resiliency intervention in nurse residents

Nurse residents are at greater risk of compassion fatigue compared to more experienced nurses. The amended 2015 Commission on Collegiate Nursing Education Standards of Entry-To-Practice Accreditation of Nurse Residency Programs require that residency programs include approaches to prevent compassion fatigue in their education experiences. This manuscript reports 6-month follow-up results of a longitudinal study in new graduate nurses that evaluated the influence of a four-hour resiliency intervention for compassion fatigue in two hospitals with nurse residency programs within an academic medical center system. We previously reported a statistically significant decrease in mean STS from baseline to 2-months (p < .001). Using a paired t-test, compassion satisfaction (CS) and the two elements of compassion fatigue (CF), secondary traumatic stress (STS) and burnout (BO), were measured against 6-month post-intervention. Prevalence and changes in mean scores were reported, suggesting that the results found at 2-month follow-up (n = 94) were sustained at 6-month follow-up (n = 34). The mean STS showed a statistically significant decrease from 2-months and 6-months (p < .001). A decrease in BO and mean increase in CS were not statistically significant, but were trending in a positive direction. As theorized, both STS and BO decreased from baseline to 2-months and 6-months after the-intervention, and CS increased. These results indicate that early compassion fatigue resiliency education may be helpful in increasing CS and lowering the symptoms of CF in nurse residents.

High Level of Emotional Intelligence is Related to High Level of Online Teaching Self-Efficacy among Academic Nurse Educators

This study examined the relationship between emotional intelligence (EI) and online teaching self-efficacy among 115 academic nurse educators who teach online (totally, blended, or both). The sample was randomly drawn from the list of nursing schools accredited by Commission on Collegiate Nursing Education (CCNE) with baccalaureate, master’s and/or doctoral programs. The hypothesis tested states “Academic nurse educators who teach online and who report higher levels of EI would also report greater online teaching self-efficacy.” Results showed a significant moderate relationship (r=0.446, p< .01) between EI and online teaching self-efficacy. The coefficient of determination R2 was 0.199, which indicates that about 20% of the variation in online teaching self-efficacy can be explained by EI contribution. The hypothesis was supported. Results also indicated that online teaching self-efficacy was positively related to duration of being an academic nurse educator (r = 0.212, p<0.05) and duration of teaching online (r = 0.203, p< 0.05). Further, there was no significant difference between the different age groups regarding EI and online teaching self-efficacy. Similarly, there was no significant difference among university degrees attained of participants regarding EI and online teaching self-efficacy. The Implications for enhancing EI and online teaching self-efficacy are discussed.

Organizational Readiness for Nurse Residency Accreditation.

Professional development nurses assume a principal role in establishing a state of readiness for accreditation of an organization's nurse residency program. This quality improvement project engaged a professional development department in self-study of their nurse residency program to determine readiness for accreditation by the Commission on Collegiate Nursing Education. The outcomes demonstrate a favorable state of organizational readiness, with minor program gaps in 19/45 accreditation criteria, requiring corrective action to optimize readiness for success.

Intervening to improve compassion fatigue resiliency in nurse residents

Nurses who are younger and new to the profession demonstrate higher prevalence of compassion fatigue compared to their more experienced counterparts. Accordingly, the Commission on Collegiate Nursing Education Standards for Accreditation recently required that nurse residency programs incorporate the teaching of strategies to prevent compassion fatigue in their learning experiences. This study examined the impact of a compassion fatigue resiliency intervention in new graduate nurse residents in two hospitals with nurse residency programs within a university health system. Compassion satisfaction and the two components of compassion fatigue (CF), secondary traumatic stress (STS) and burnout (BO), were measured at baseline and 2-month follow-up. Changes in mean scores and prevalence were reported. A statistically significant decrease in mean STS from baseline to follow-up was found ( p < .001). A mean increase in CS and decrease in BO were trending in the desired direction but were not statistically significant. As hypothesized, prevalence of CS increased and STS and BO decreased from baseline to 2-months post intervention.The results suggest that compassion fatigue interventions may be beneficial to nurse residents in decreasing CF symptoms and increasing CS early in their careers. More research is needed to understand the optimal timing and type of intervention.

Regulation of Distance Nursing Education Programs: One University’s Experience

The 2010 U.S. Department of Education Regulation on Program Integrity has significantly impacted all nursing programs using online education to reach students outside their state by adding substantial reporting requirements. Without a national clearinghouse for state authorization information, these nursing programs had to develop their own strategies. Administrators must understand the State Authorization Reciprocity Agreement and individual state requirements and expend significant resources in staff time and application fees to comply with regulatory requirements. The purpose of this article is to describe one university's experience with the processes and challenges associated with obtaining state authorization for three online nursing programs accredited by the Commission on Collegiate Nursing Education.

Mastering the Journey to Continuous Compliance

The accreditation process of a nursing program requires self-assessment, peer evaluation, and identifying areas of improvement. In 2008, the Commission on Collegiate Nursing Education (CCNE) began offering a 10-year accreditation with a Continuous Improvement Progress Report (CIPR) at the fifth year. This article focuses on an in-depth analysis of a system in which the school of nursing utilized an ad hoc committee to complete the CIPR. Reports generated by the ad hoc committee concluded that need for improvement was warranted related to policy review. An action plan for continuous compliance generated implementation of policy software and the creation of an academic support specialist position. An ad hoc committee completed the CIPR rather than paying faculty overload hours; policy was an exemplar. Faculty development, team performance, and accountability resulted in a plan for continual compliance that can be adopted in other nursing schools to meet CCNE accreditation.