Trends in Nursing Education 5 25
Content
Trends in Nursing Education In 2003, George Keller, noted strategist, listed six trends that will influence the future of higher education. (I have shared this listing and implications for higher ed with you.) 1. Birth rates in the United States are decreasing 2. We are becoming a geriatric society 3. Immigration is coming from cultures that are very different from the immigrants that arrived in the past. 4. The American family is changing. 5. The U.S. population is becoming increasingly inter-racial, inter-ethnic, and inter-religious. 6. Demographic changes are creating new socioeconomic class structure. 7. In 2000, Authur Levine, President of Teachers College of Columbia University, listed other trends that will influence higher education: 1. 2. 3. 4. Shifting demographics, New technologies The entrance of commercial organizations into higher education The changing relationship between the university and the state and federal government 5. The move from an industrial to an information society 6. The convergence of publishing, broadcasting, telecommunications, and education He predicts that: 1. Higher education providers will become more numerous and diverse, more competitive. 2. Technological capabilities are encouraging global universities that can respond quickly with high-quality education to an international student body. Expect Brand names in higher ed 3. Three kinds of universities: Traditional residential; commercial virtual; and combination of the two. The combo will be the most competitive and attractive to students. 4. Higher ed is becoming more individualized: students will set the educational agenda. Any time, any place education will be demanded.
5. There is a shift from teaching to learning with a focus on 6.
7. 8. 9.
educational outcomes For profit and other new providers who are only interested in teaching will compete with the university’s mission of teaching, research, and service. Faculty will become increasingly independent of universities Degrees will wither in importance: competencies and skills will be list on transcripts or in portfolios Dollars will follow students not educators.
Trend #1: Accelerated nursing programs. By 2010, more than a million more RNs will be needed and nursing schools around the country are exploring creative ways to increase student capacity. One popular way to increase the RNS in the workforce is to create accelerated programs. Accelerated BSN and Masters degree program for non-nursing graduates. BSN programs: 12-18 months long. Generic master's programs: approximately 3 yrs. In 1990, 31 accelerated BSN and 12 generic master's programs. Today, 133 accelerated BSN programs and 36 generic master's programs. 50 new accelerated BSN programs are now in the planning stages. 18 new generic master's programs are also taking shape. Are we ready to accelerate our BSN program? When will be able to increase our MEPN enrollment? How large should this program be? Trend #2: Increase need for BSN preparation. The National Advisory Council on Nurse Education and Practice (NACNEP), policy advisors to Congress and the U.S. Secretary for
Health and Human Services on nursing issues, has urged that at least two-thirds of the nurse workforce hold baccalaureate or higher degrees in nursing by 2010. Currently, only 43% of nurses hold degrees at the baccalaureate level and above. NACNEP found that nursing's role for the future calls for RNs to manage care along a continuum, to work as peers in interdisciplinary teams, and to integrate clinical expertise with knowledge of community resources. The increased complexity of the scope of practice for RNs requires a workforce that has the capacity to adapt to change. It requires: • critical thinking and problem solving skills; • a sound foundation in a broad range of basic sciences; • knowledge of behavioral, social and management sciences; and • the ability to analyze and communicate data. How do can we maintain/increase our enrollment in the BSN and graduate programs in nursing? What is the ideal balance between undergrads and grads enrollment for our School? How can we encourage multiple entry and exits points into our academic programs? Trend #3: Faculty Shortage: AACN data show that more than 11,000 applicants were turned away from BSN programs last year due primarily to a shortage of faculty. (clinical sites and classroom space were other reasons) With the average age of doctorally-prepared faculty currently 54.1 yrs, a wave of retirements is expected within the next ten years. AACN projects that between 200 and 300 doctorally-prepared faculty will be eligible for retirement each year from 2003 through 2012, and
between 220-280 master's-prepared nurse faculty will be eligible for retirement between 2012 and 2018. The AACN survey also found that though enrollments were up in both master’s and doctoral degree nursing programs, the number of graduates from these programs is still declining. Enrollments in master’s degree programs rose 10.2 percent (3,350 students) with a total student population of 37,251. In doctoral programs, enrollments increased by 5.6 percent (171 students) bringing the total student population to 3,229. Though enrollments increased, the number of graduates from master’s and doctoral programs declined by 2.5 percent and 9.9 percent, respectively. Given the competition for nurses prepared at advanced levels and the salary differential between positions in higher education and private practice, the nurse faculty shortage is expected to intensify and impact nursing education programs at all levels. What can we do to retain our faculty talent? How can we prepare nurses for the faculty role? Trend #4: Need for BSN-RN programs. With more nurses in ADN programs, the need for articulation to BSN programs will continue. From 2002 to 2003, enrollments in RN-to-BSN programs increased by 8.1% or 2,215 students, which makes this enrollment increase the first in six years. Can we increase enrollment in our RN-BSN program? Can we crate an RN-MN or PHD program? Trend #5: In the 2003, IOM report: A new vision for health professions education, they state:
“All health professionals should be educated to deliver patientcentered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.” How do our academic programs compare with this vision? Trend #6: AACN’s Clinical nurse leader at the masters level The CNL is a leader in health care delivery systems across all settings in which health care is delivered. This role is neither management nor administration. The CNL assumes accountability for client outcomes through the assimilation and application of research-based information to design, implement, and evaluate client’s plans of care. The CNL is a provider and manager of care for individuals and populations. The CNL designs, implements, and evaluates client care by coordinating, delegating, and supervising the care provided by the health team. Do we currently prepare students for this “new role”? Is this role similar to or different from CNS preparation?
Trend #7: Practice doctorate in nursing The AACN has recommended the practice doctorate as a distinct model of doctoral education that provides graduates at the highest level of nursing practice. This degree should be the graduate degree for advanced practice preparation. Current AP roles are CNS, NP, CNM, and CRNA. They have outlined the content areas that are essential: 1. Scientific underpinnings for practice 2. Advanced nursing practice
3. Organizational and system leadership/management; quality
4.
5.
6. 7.
improvement and system thinking Analytic methods related to evaluation of practice and the application of evidence for practice Use of technology and information to improve and transform health care Health policy development, implementation, and evaluation Interdisciplinary collaboration for improving patient and population health care outcomes.
Do we want to transform our MN program into a DN? Should we offer the MN along the way? Do we think the DN could be a generic program? How do we preserve multiple entry and exit points?
5. There is a shift from teaching to learning with a focus on 6.
7. 8. 9.
educational outcomes For profit and other new providers who are only interested in teaching will compete with the university’s mission of teaching, research, and service. Faculty will become increasingly independent of universities Degrees will wither in importance: competencies and skills will be list on transcripts or in portfolios Dollars will follow students not educators.
Trend #1: Accelerated nursing programs. By 2010, more than a million more RNs will be needed and nursing schools around the country are exploring creative ways to increase student capacity. One popular way to increase the RNS in the workforce is to create accelerated programs. Accelerated BSN and Masters degree program for non-nursing graduates. BSN programs: 12-18 months long. Generic master's programs: approximately 3 yrs. In 1990, 31 accelerated BSN and 12 generic master's programs. Today, 133 accelerated BSN programs and 36 generic master's programs. 50 new accelerated BSN programs are now in the planning stages. 18 new generic master's programs are also taking shape. Are we ready to accelerate our BSN program? When will be able to increase our MEPN enrollment? How large should this program be? Trend #2: Increase need for BSN preparation. The National Advisory Council on Nurse Education and Practice (NACNEP), policy advisors to Congress and the U.S. Secretary for
Health and Human Services on nursing issues, has urged that at least two-thirds of the nurse workforce hold baccalaureate or higher degrees in nursing by 2010. Currently, only 43% of nurses hold degrees at the baccalaureate level and above. NACNEP found that nursing's role for the future calls for RNs to manage care along a continuum, to work as peers in interdisciplinary teams, and to integrate clinical expertise with knowledge of community resources. The increased complexity of the scope of practice for RNs requires a workforce that has the capacity to adapt to change. It requires: • critical thinking and problem solving skills; • a sound foundation in a broad range of basic sciences; • knowledge of behavioral, social and management sciences; and • the ability to analyze and communicate data. How do can we maintain/increase our enrollment in the BSN and graduate programs in nursing? What is the ideal balance between undergrads and grads enrollment for our School? How can we encourage multiple entry and exits points into our academic programs? Trend #3: Faculty Shortage: AACN data show that more than 11,000 applicants were turned away from BSN programs last year due primarily to a shortage of faculty. (clinical sites and classroom space were other reasons) With the average age of doctorally-prepared faculty currently 54.1 yrs, a wave of retirements is expected within the next ten years. AACN projects that between 200 and 300 doctorally-prepared faculty will be eligible for retirement each year from 2003 through 2012, and
between 220-280 master's-prepared nurse faculty will be eligible for retirement between 2012 and 2018. The AACN survey also found that though enrollments were up in both master’s and doctoral degree nursing programs, the number of graduates from these programs is still declining. Enrollments in master’s degree programs rose 10.2 percent (3,350 students) with a total student population of 37,251. In doctoral programs, enrollments increased by 5.6 percent (171 students) bringing the total student population to 3,229. Though enrollments increased, the number of graduates from master’s and doctoral programs declined by 2.5 percent and 9.9 percent, respectively. Given the competition for nurses prepared at advanced levels and the salary differential between positions in higher education and private practice, the nurse faculty shortage is expected to intensify and impact nursing education programs at all levels. What can we do to retain our faculty talent? How can we prepare nurses for the faculty role? Trend #4: Need for BSN-RN programs. With more nurses in ADN programs, the need for articulation to BSN programs will continue. From 2002 to 2003, enrollments in RN-to-BSN programs increased by 8.1% or 2,215 students, which makes this enrollment increase the first in six years. Can we increase enrollment in our RN-BSN program? Can we crate an RN-MN or PHD program? Trend #5: In the 2003, IOM report: A new vision for health professions education, they state:
“All health professionals should be educated to deliver patientcentered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.” How do our academic programs compare with this vision? Trend #6: AACN’s Clinical nurse leader at the masters level The CNL is a leader in health care delivery systems across all settings in which health care is delivered. This role is neither management nor administration. The CNL assumes accountability for client outcomes through the assimilation and application of research-based information to design, implement, and evaluate client’s plans of care. The CNL is a provider and manager of care for individuals and populations. The CNL designs, implements, and evaluates client care by coordinating, delegating, and supervising the care provided by the health team. Do we currently prepare students for this “new role”? Is this role similar to or different from CNS preparation?
Trend #7: Practice doctorate in nursing The AACN has recommended the practice doctorate as a distinct model of doctoral education that provides graduates at the highest level of nursing practice. This degree should be the graduate degree for advanced practice preparation. Current AP roles are CNS, NP, CNM, and CRNA. They have outlined the content areas that are essential: 1. Scientific underpinnings for practice 2. Advanced nursing practice
3. Organizational and system leadership/management; quality
4.
5.
6. 7.
improvement and system thinking Analytic methods related to evaluation of practice and the application of evidence for practice Use of technology and information to improve and transform health care Health policy development, implementation, and evaluation Interdisciplinary collaboration for improving patient and population health care outcomes.
Do we want to transform our MN program into a DN? Should we offer the MN along the way? Do we think the DN could be a generic program? How do we preserve multiple entry and exit points?
