New Pathways from ADN to BSN

16 Pages·2013·0.13 MB·English

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New Pathways from ADN to BSN: The Blended Learning
Model to Build Capacity in the Incumbent Nursing Workforce

Massachusetts Department of Higher Education
Nursing Education Re-Design Grant Program
Final Project Implementation Report

Reporting Period: June 1, 2012 – December 31, 2013

Principal Investigator: Dr. Stephanie Chalupka

Submitted by: Worcester State University and UMass Memorial Medical Center
December 31, 2013
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I. Executive Summary/Overview of Project Accomplishments

Worcester State University (WSU), the Central Massachusetts leader in providing ADN-to-BSN and
ADN-to-MSN education for practicing registered nurses, and University of Massachusetts Memorial
Medical Center (UMMMC) developed and implemented an innovative ADN-to-BSN educational program
delivered in the blended-learning format on the UMMMC campuses.
With only 52% of the nurses in Central Massachusetts prepared at the baccalaureate or higher
degree level, WSU/UMMMC developed an easily replicated model as a method to reach the Institute of
Medicine’s goal of 80% of the RN workforce educated at the BSN level or higher and the corresponding
goals for Massachusetts detailed in Nursing And Allied Health Workforce Development: A Strategic
Workforce Plan for Massachusetts’ Healthcare Sector (MA DHE, 2012).
Funding from the DHE Nursing and Allied Health Initiative supported the development, launch, and
institutionalization of the ADN-to-BSN track promoting seamless, upward mobility for an incumbent
workforce to advance their education from AND-to-BSN or higher.
This program was based on a needs assessment conducted in December 2011 and a subsequent pilot
study completed by the academic/practice (WSU/UMMMC) partners. This new pathway to BSN for
associate degree-prepared nurses to the BSN is a model for seamless upward educational mobility that can
easily be replicated by other academic/practice partnerships across the Commonwealth and nationally. With
funding from this grant, the WSU/UMMMC partners were be able to: 1) Plan and develop ADN-to-BSN
curriculum, to be delivered in the blended-learning format, and implemented by WSU on the UMMMC
hospital campuses in Fall 2012 with 25 ADN-to BSN students; 2) Plan, develop, and implement effective
academic success and retention strategies to increase ADN student readiness to undertake BSN (or ADN to
MSN) studies thereby improving retention and graduation rates; 3) Increase the number of nurses in Central
Massachusetts prepared with a baccalaureate degree (or higher) to promote better patient outcomes; 4)
Disseminate best practices in ADN- to-BSN education delivered in the blended-learning format, using an
academic/practice partnership model to other universities and hospitals through conference presentations and
publications. The second ADN- to-BSN cohort entered in fall 2013 and the third will enter in January 2014.
The final product is a sustainable and replicable model of nursing education for seamless upward
educational mobility for associate degree-prepared nurses to earn a BSN.
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II. Research Findings to Date

Research Question 1: What role did support strategies implemented as part WSU/UMMMC
Collaborative RN-to-BSN play in academic success and retention of first cohort?

The support strategies included in the WSU/UMMMC Collaborative RN-to-BS Program were
extremely effective in academic success and retention of first cohort with 90% of students
strongly agreeing that the Strategies for Academic Success course both eased their transition into
the student role (Please refer to Figure 1.) and 95% agreeing that the course was a significant
factor in their success in completing the first year of studies (Please refer to Figure 2.). Learning
in the electronic environment and learning to use electronic library data bases were
overwhelmingly identified by the students as the most helpful topics within the course (Please refer
to Figure 3).

Figure 1: Strategies for Academic Success Course Helped to Ease Transition to Student Role

The Strategies for Academic Success
Course Helped to Ease My Transition
to Student Role
n=23
Strongly Agree 90%
Agree 10%
Neither Agree or Disagree
0%
Disagree 0%
Strongly Disagree 0%
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Figure 2: Strategies for Academic Success Was a Significant Factor in Success in
Year I of the Program
Strategies for Academic Success Was a
Significant Factor in My Own Sucess in
Year I of the Program
n=24

Strongly Agree 93%
Agree 3%
Neither Agree Nor
Disagree 0%
Disagree 0%
Stronly Disagree 0%

Figure 3: Most Helpful Component of Strategies for Academic Success
Most Helpful Component of Strategies for
Academic Success
n=24
Learning in the Electronic
Environment 39%
Library Database Searching
30%
Time Management 5%
Presentation Skills 21%
Other 5%
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Research Question 2: What are the identified barriers to enrollment and incentives to persist
in ADN-BSN (ADN-MSN) completion programs?

Information about student identified barriers to enrollment and incentives to persist in ADN-
BSN and AND-MSN are presented in Figures 4 and 5. Qualitative data derived from focus
groups and in-depth interviews are provided in Figure 6.

Figure 4: Barriers to Enrollment in ADN- to-BSN Program
Barriers to Enrollment in
ADN-to-BSN Program
n=24
Financial 4%
Personal Responsibilites 5%
Ability to GetWork Schedule
Accomodation 39%
Difficulty with Transfer Process
52%
Other, please specify 0%

Figure 5: Perceived Incentives to Persist in ADN-to-BSN Program
Perceived Incentives to Persist in
ADN-to-BSN Program
n=24
Encouragement Support from
Employer 3%
Support from Cohort 34%
Support from WSU
Advisor/Faculty33%
Worksite Location Convenience
31%
Cost 2%
Other, please specify: 0%
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Focus Groups and In-Depth Interviews

Methods:
Two types of qualitative research methods were employed: staff nurse/student focus groups
(conducted at the end of the first semester) and in-depth interviews (conducted at the end of the
conclusion of first year of studies). The intent of the focus groups and was to elucidate the
general nature of the returning student experience particularly barriers and incentives to enroll
and persist. The in-depth interviews sought to complement the focus groups by providing
further insights into the student experience with emphasis on retention and progress toward
completion after completing one year of the program.

Recruitment of Focus Group Participants:
We recruited volunteer participants from each hospital campus. The only criterion for
participation in the focus group was that participants must have completed one semester in the
WSU/UMMMC Collaborative RN-to-BS Program.

Focus groups and interviews were conducted at each hospital campus. No participant
participated on their work time and no stipend was paid, however, refreshments were provided.

All focus groups were moderated by the same researcher, supported by assistants who took
handwritten notes, oversaw tape recording, and performed other functional tasks. The typed
transcripts were verified and analyzed thematically using NVivo10 qualitative research
software.
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Figure 6: Themes which Emerged from Focus Groups
____________________________________________________________________________
Advantages and Challenges of Academic Progression In Nursing Described in Focus
Groups and Interviews
Cited in:
_______________________________
Focus Groups Interview
____________________________________________________________________________

Advantages

Opportunity to fulfill personal goal X

Onsite program provided important opportunity X X
(may not have actually ever pursued degree
without this program)

Opportunity for advancement within organization X X

Tuition and book benefit in union contract X X

Support from cohort to keep going X X

Strategies for Academic Success Course X X

See new challenges and opportunities in current practice X X

Feel re-energized about nursing X

Greater job satisfaction X

Challenges

Financial (Return to school may mean need to forgo X
income or assume additional debt to pay tuition)

No pay differential with BS degree X X

Limit on employers offered tuition assistance X
for part-time employees

Lack of flexibility in scheduling at work X X

Disruption of family life (limited number of time requests X
per month means choosing between school or family)
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Research Question 3: Will the increased accessibility provided by an on-site blended-learning
approach for ADN-BSN (or ADN-MSN) education promote an increase in the incumbent
workforce able to advance their education?

The actual number of qualified applicants to each program was 48 prospective students to
the WSU On-Campus RN-to-BS Program and 25 qualified applicants to the WSU/UMMMC
Collaborative RN-to-BS Program.

One-hundred percent of those offered admission to the UMMMC program accepted but
only 30 students accepted a place in the Fall 2012 incoming class and 100% of the 25 students who
applied to the WSU/UMMMC Collaborative RN-to-BS Program accepted the offer of admission
and matriculated. This willingness to accept the offer of admission, as well as increased percentage
of students completing the first year of studies in the WSU/UMMMC Collaborative RN-to-BS
Program, as compared (please refer to Figure 6) with the traditional on-campus WSU RN-to-BS
Program offered in the fully face-to-face mode suggest that the on-site blended approach suggests
that the increased accessibility facilitates academic progression in nursing.

In addition, 3 of the 24 students in the WSU/UMMMC Collaborative RN-to-BS Program
elected to matriculate in the RN-to-MS Fast Track Program while only 2 students of the 24 WSU
on-campus students who persisted to the end of the first semester elected the RN-to-MS Fast Track
option.

Research Question 3: Will increased accessibility and flexibility provided by this approach
promote successful completion of an ADN-BSN (or ADN-MSN) program equal to or greater
than existing traditional face-to-face on-campus RN-BSN completion programs?

Enrollment trends for students entering the WSU on-campus RN-to-BS and the
WSU/UMMMC Collaborative Program in Fall 2013 was compared. As illustrated in
Figure 6, more students accepted the offer of admission to the WSU/UMMMC Collaborative RN-
to-BS program and significantly more persisted in the first year. One student in the WSU/
UMMMC Collaborative Program was counseled out of the program. The students in the
WSU/UMMMC Collaborative RN-to-BS program are only in their second year of the program so
completion data are not available at this time. However, data will continue to be collected to
assess and complete completion rates.
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Figure 6: Enrollment Trends in RN-to-BS Program on Worcester State University Campus
(Delivered Fully Face-to-Face) Compared with Enrollment Trends in WSU/UMMMC
Collaborative Program (Delivered in the Blended-Learning Format)
35
30
24
25
21
20
Acepted Offer of Admission for
September 2012
15
Completing End of Semester I
10
5
0
BS Program onBS Program on
WSU Campus UMMMC
Campus
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III. Changes Implemented and Plan for Sustainability

Some curricular changes resulted from formative and summative evaluation by students. In particular,
the clinical experience associated with NU 432: Advancing Perspectives in Chronic Illness was restructured to
enable student to have clinical practicum on their scheduled class day.

Additionally, changes were made in the method of delivery of NU 432: Health Assessment. This
change resulted from limitations in the hospital physical environment for student practice activities. The
decision was made by the students to have this single class held at the health assessment labs on the Worcester
State University campus rather than at the hospital where facilities presented a challenge for practice sessions.

Finally, resources from an additional $60,000 award from the Fairlawn Foundation of the Greater
Worcester Community Foundation for AND-to-BS education have been directed toward the New Pathways
from ADN to BSN: The Blended Learning Model to Build Capacity in the Incumbent Nursing Workforce
program. This has greatly enhanced our ability to provide support services on the UMMMC campuses. In
addition, in the first year of the grant UMMMC made an unanticipated contribution to support an additional 10
hours per month for academic advising and tutoring services on their campuses, greatly enhancing our scope of
services. This project met or exceeded all goals and remained within our proposed budget.

As a result of this successful academic-practice partnership and the overall satisfaction with the
WSU/UMMMC Collaborative RN-to-BS program, both partners remain fully committed to continuing the
collaborative program. In addition, this model has been extended to include all 5 partner hospitals in the UMass
Memorial Health Care System, UMass Memorial Medical Center [University and Memorial Campuses], Wing
Memorial Hospital, Marlboro Hospital, and Health Alliance Hospitals [Burbank and Fitchburg Campuses].
This provides opportunities for seamless academic progression to over 3,000 nurses system wide.

IV. Barriers Encountered/Addressed

In October 2012, Dr. Margaret Laccetti, UMMMC Associate Chief Nursing Officer and liaison with
UMMMC nursing workforce left the employ of UMMMC. The role previously performed by Dr. Laccetti was
assumed by Karen Utarro and later Carolyn Catton, Director of Nursing Professional Development. Jackie
McGravey, Director of Workforce Planning and Analytics for the University of Massachusetts Memorial Health
Care (UMMHC) has worked closely with both Ms. Utarro and later Carolyn Catton to facilitate both periods of
transition.

In the spring of 2013 labor unrest and the threat of an impending strike at UMMMC had a significantly
adverse impact on our students recruiting efforts. Only 14 qualified students applied for admission to Cohort II.
All qualified students were admitted and accepted the offer of admission. However, this uncertainty
surrounding the impending strike resulted in our not meeting our enrollment goal of 35 for the class entering in
September 2013. After the labor dispute was successfully concluded we began additional recruiting efforts.
We admitted ten additional students who will join Cohort II in January 2014 bringing Cohort II to 25. We will
offer the Strategies for Academic Success course in January and the Fall course that they missed in 2013 in
Summer Session I (2014) to enable these additional 10 students to progress with the rest of Cohort II. We are
pleased to report that interest has been strong at information sessions for Cohort III (Class entering Fall 2014).