WEBVTT 00:00:00.300 --> 00:00:05.980 position:50% align:middle - [Host] Judy Liesveld is a professor, and is the Associate Dean for Education and Innovation 00:00:05.980 --> 00:00:08.310 position:50% align:middle at the University of New Mexico. 00:00:08.310 --> 00:00:13.860 position:50% align:middle Dr. Liesveld is on the Leadership Council for the New Mexico Nursing Education Consortium, 00:00:13.860 --> 00:00:20.440 position:50% align:middle a partnership of all 18 state funded schools, bringing the BSN to community colleges. 00:00:20.440 --> 00:00:27.060 position:50% align:middle Dr. Liesveld has been a nurse for over 30 years, in nursing education, community health, school nursing, 00:00:27.060 --> 00:00:29.809 position:50% align:middle primary care, and prison nursing. 00:00:36.500 --> 00:00:38.240 position:50% align:middle - [Judy Liesveld] Thank you for introducing me. 00:00:38.240 --> 00:00:44.303 position:50% align:middle I'm Judy Liesveld, and I'm from the University of New Mexico, and I'm pleased to present our project 00:00:44.303 --> 00:00:52.903 position:50% align:middle called, "Are there Outcome Differences Between NMNEC ADN, BSN and ADN/BSN Co-enrolled Students: 00:00:52.903 --> 00:00:56.991 position:50% align:middle Results of the NCSBN Research Project." 00:00:59.430 --> 00:01:02.330 position:50% align:middle So what sparked this project? 00:01:02.330 --> 00:01:06.700 position:50% align:middle The New Mexico Nursing Education Consortium, which we call NMNEC, 00:01:06.700 --> 00:01:12.240 position:50% align:middle includes 12 state funded schools in 16 locations in New Mexico. 00:01:12.240 --> 00:01:19.790 position:50% align:middle This includes ADN, BSN, and ADN/BSN co-enrolled students with a community 00:01:19.790 --> 00:01:22.520 position:50% align:middle college and university. 00:01:22.520 --> 00:01:28.550 position:50% align:middle Courses for co-enrolled students are totally taught on the community college campuses. 00:01:28.550 --> 00:01:34.450 position:50% align:middle All schools also share a common statewide concept-based curriculum. 00:01:34.450 --> 00:01:37.470 position:50% align:middle Our model needed rigorous testing. 00:01:37.470 --> 00:01:42.799 position:50% align:middle Funding was applied for through NCSBN's Center for Regulatory Excellence. 00:01:45.600 --> 00:01:49.350 position:50% align:middle This is a slide of our NMNEC Educational Model. 00:01:49.350 --> 00:01:54.750 position:50% align:middle As you can see on the left, the prerequisites all filter into the pre-licensure 00:01:54.750 --> 00:01:57.630 position:50% align:middle degree options, which there are three. 00:01:57.630 --> 00:02:06.430 position:50% align:middle The university BSN, the community college/university partnership BSN, or the community college ADN. 00:02:06.430 --> 00:02:12.435 position:50% align:middle And then, of course, from there, we encourage students to go on for higher education. 00:02:14.040 --> 00:02:18.900 position:50% align:middle We wanted to align our study, of course, with nursing regulation. 00:02:18.900 --> 00:02:24.320 position:50% align:middle And as you may recall, several years ago NCSBN had a project called Taxonomy 00:02:24.320 --> 00:02:28.890 position:50% align:middle of Error Root Cause Analysis of Practice, or TERCAP. 00:02:28.890 --> 00:02:36.870 position:50% align:middle TERCAP's goal was to categorize and track practice breakdown with a comprehensive standardized system. 00:02:36.870 --> 00:02:43.480 position:50% align:middle Clinical reasoning and professional responsibility, or values, were found to be the top two reasons 00:02:43.480 --> 00:02:45.280 position:50% align:middle for practice breakdown. 00:02:46.440 --> 00:02:52.410 position:50% align:middle So the purpose of our study became: How can NMNEC show that we are graduating safe, 00:02:52.410 --> 00:02:58.300 position:50% align:middle competent, professional students with excellent clinical reasoning skills? 00:02:58.300 --> 00:03:05.770 position:50% align:middle Our hypotheses became to determine if there are differences in clinical reasoning, professional values, 00:03:05.770 --> 00:03:12.840 position:50% align:middle motivation, and demographics for senior-level nursing students in the NMNEC Curriculum between the three 00:03:12.840 --> 00:03:19.170 position:50% align:middle sectors of students: the ADN students, the university based BSN students, 00:03:19.170 --> 00:03:26.090 position:50% align:middle and the community college/university ADN/BSN co-enrolled students. 00:03:26.090 --> 00:03:29.618 position:50% align:middle These are the participating NMNEC schools. 00:03:29.860 --> 00:03:36.700 position:50% align:middle As you can see, we had four community college pre-licensure ADN and co-enrolled pre-licensure 00:03:36.700 --> 00:03:42.430 position:50% align:middle BSN schools, and two university pre-licensure BSN schools. 00:03:42.430 --> 00:03:48.850 position:50% align:middle IRB was obviously obtained and letters of support were also obtained. 00:03:48.850 --> 00:03:55.630 position:50% align:middle The criteria was that each of these schools did need to be teaching the NMNEC Curriculum for at least one year 00:03:55.630 --> 00:03:57.680 position:50% align:middle to participate in the study. 00:03:59.430 --> 00:04:03.320 position:50% align:middle This is a slide that shows our grant team. 00:04:03.320 --> 00:04:09.142 position:50% align:middle Our funding was between April 1, 2017 and March 30, 2019. 00:04:09.142 --> 00:04:15.450 position:50% align:middle And our personnel included not only myself, but Beth Rodgers with Virginia Commonwealth University, 00:04:15.450 --> 00:04:22.970 position:50% align:middle she was a Co-PI, Mary Wright was our project outreach manager, Blake Boursaw, our statistician, 00:04:22.970 --> 00:04:28.808 position:50% align:middle and Jenny Landen also consulted with us from the community college perspective. 00:04:30.540 --> 00:04:34.510 position:50% align:middle So senior level nursing students, near the end of their program at each 00:04:34.510 --> 00:04:40.310 position:50% align:middle participating school, were invited to complete four paper and pencil research 00:04:40.310 --> 00:04:43.910 position:50% align:middle instruments at the end of their programs. 00:04:43.910 --> 00:04:46.140 position:50% align:middle So, the ADN program was at Level 4. 00:04:46.140 --> 00:04:52.660 position:50% align:middle These were senior students, and the pre-licensure BSN and co-enrolled ADN/BSN were 00:04:52.660 --> 00:04:55.835 position:50% align:middle Level 5, or also senior students. 00:04:57.970 --> 00:05:00.470 position:50% align:middle We had several research instruments. 00:05:00.470 --> 00:05:04.220 position:50% align:middle We had a brief custom demographic instrument. 00:05:04.220 --> 00:05:09.980 position:50% align:middle The Script Concordance Test was selected for measuring clinical reasoning. 00:05:09.980 --> 00:05:16.410 position:50% align:middle The Nurses Professional Values Scale was selected to look at professional value identity in RNs, 00:05:16.410 --> 00:05:21.120 position:50% align:middle and the Academic Motivation Scale was also used. 00:05:21.120 --> 00:05:25.933 position:50% align:middle All of these had great Cronbach alpha results. 00:05:29.570 --> 00:05:37.710 position:50% align:middle So the Script Concordance Test is a very interesting survey that's given to students, or nurses. 00:05:37.710 --> 00:05:40.510 position:50% align:middle The person is presented with a scenario. 00:05:40.510 --> 00:05:45.300 position:50% align:middle For instance, in this scenario, the woman is 78 years old. 00:05:45.300 --> 00:05:49.590 position:50% align:middle She's complaining of difficulty breathing, and it's gotten worse over a few days. 00:05:49.590 --> 00:05:55.510 position:50% align:middle She does suffer from COPD, which is obstructive and chronic, 00:05:55.510 --> 00:05:57.030 position:50% align:middle and she's had this for several years. 00:05:57.030 --> 00:06:03.840 position:50% align:middle But she asks you, as the nurse, if she can go outside to smoke without her oxygen. 00:06:03.840 --> 00:06:10.630 position:50% align:middle So then, what happens, the student is presented an "if you think" scenario. 00:06:10.630 --> 00:06:12.020 position:50% align:middle So, if you think that Ms. 00:06:12.020 --> 00:06:18.640 position:50% align:middle Davis is not aware of the seriousness of her condition, and that she denies her state of health, 00:06:18.640 --> 00:06:23.490 position:50% align:middle and then you find, for instance, that her oxygen saturation of 91%, 00:06:23.490 --> 00:06:29.690 position:50% align:middle with oxygen in place, then you get to select the hypothesis, 00:06:29.690 --> 00:06:32.550 position:50% align:middle from a minus two to a two. 00:06:32.550 --> 00:06:38.170 position:50% align:middle Minus two means that the hypothesis is rejected, and all the way up to a two, 00:06:38.170 --> 00:06:42.680 position:50% align:middle which means that it needs to be explored in the immediate future. 00:06:42.680 --> 00:06:48.290 position:50% align:middle So this is a really interesting way to measure clinical reasoning. 00:06:48.290 --> 00:06:53.090 position:50% align:middle The next scale that we used was the Nurses Professional Values Scale. 00:06:53.090 --> 00:06:59.720 position:50% align:middle This one includes value statements such as assume responsibility for meeting health needs of the 00:06:59.720 --> 00:07:02.440 position:50% align:middle culturally diverse population. 00:07:02.440 --> 00:07:08.980 position:50% align:middle Then the student answers A equals not important, all the way up to E equals most important, 00:07:08.980 --> 00:07:13.032 position:50% align:middle if they consider that a high value of theirs. 00:07:14.200 --> 00:07:18.960 position:50% align:middle The next scale that was used was the Academic Motivation Scale. 00:07:18.960 --> 00:07:25.470 position:50% align:middle This includes, for example, an item might say, "Because with only a high school degree I would not 00:07:25.470 --> 00:07:28.680 position:50% align:middle find a high-paying job later on." 00:07:28.680 --> 00:07:34.870 position:50% align:middle And then the student would answer one, does not correspond to reasons why you would go 00:07:34.870 --> 00:07:39.570 position:50% align:middle to college, to seven, which corresponds exactly to why you would 00:07:39.570 --> 00:07:41.008 position:50% align:middle go to college. 00:07:45.050 --> 00:07:48.870 position:50% align:middle So, participation by the students was, of course, voluntary. 00:07:48.870 --> 00:07:53.650 position:50% align:middle They completed this near the end of their program during regular class time. 00:07:53.650 --> 00:07:59.140 position:50% align:middle We did find that all of the surveys took quite a bit of time, 75 to 90 minutes. 00:07:59.140 --> 00:08:07.750 position:50% align:middle So each cohort of students was given a $150 gift certificate for the cohort to use collectively in any 00:08:07.750 --> 00:08:10.780 position:50% align:middle manner that they desired. 00:08:10.780 --> 00:08:15.820 position:50% align:middle The course instructor was not in the room during the time that the surveys were administered. 00:08:15.820 --> 00:08:22.480 position:50% align:middle However, another unbiased faculty member was in the room with the students during the completion 00:08:22.480 --> 00:08:24.410 position:50% align:middle of the surveys. 00:08:24.410 --> 00:08:28.880 position:50% align:middle So there was no linkage to any individual student. 00:08:28.880 --> 00:08:33.440 position:50% align:middle The data was analyzed by our statistician and project co-investigators. 00:08:33.440 --> 00:08:37.265 position:50% align:middle And, of course, we made quarterly reports to NCSBN. 00:08:38.720 --> 00:08:44.780 position:50% align:middle So, our statistical analysis, we use means and standard deviations that were 00:08:44.780 --> 00:08:53.240 position:50% align:middle calculated for instrument scale and subscale scores, and then compared across educational patterns, the ADN, 00:08:53.240 --> 00:09:00.940 position:50% align:middle the co-enrolled ADN/BSN in community college environments, and the traditional university-based BSN. 00:09:00.940 --> 00:09:06.740 position:50% align:middle We used ANOVAS with planned pairwise post hoc comparisons. 00:09:06.740 --> 00:09:12.544 position:50% align:middle Statistical significance for all analyses was set at 0.05. 00:09:13.431 --> 00:09:22.813 position:50% align:middle For our sample size we ended up with surveys from 569 students in the final term of their programs. 00:09:22.813 --> 00:09:29.560 position:50% align:middle 207 were ADN students, 232 were university-based BSN students, 00:09:29.560 --> 00:09:35.969 position:50% align:middle and 130 were co-enrolled ADN/BSN community college students. 00:09:38.370 --> 00:09:43.350 position:50% align:middle For the instrument results, we found that students did not show statistically 00:09:43.350 --> 00:09:49.980 position:50% align:middle significant different scores by educational pattern on the Academic Motivation Scale or the Nurses 00:09:49.980 --> 00:09:53.630 position:50% align:middle Professional Values Scale-Revised. 00:09:53.630 --> 00:09:59.240 position:50% align:middle However, the Script Concordance Test, which are on a 0 to 100 scale, 00:09:59.240 --> 00:10:07.900 position:50% align:middle did vary significantly by educational pattern, showing higher scores with the ADN students than the 00:10:07.900 --> 00:10:12.230 position:50% align:middle BSN students, but not the co-enrolled students. 00:10:12.230 --> 00:10:26.995 position:50% align:middle The effect size was, however, small, at .02, with .01, .06, and .14, respectively, as small, 00:10:26.995 --> 00:10:29.024 position:50% align:middle medium, and large. 00:10:31.380 --> 00:10:36.998 position:50% align:middle So, in our discussion, we found that it seemed that traditional BSN students 00:10:36.998 --> 00:10:44.546 position:50% align:middle on university campuses and ADN and BSN/ADN co-enrolled students on community college campuses 00:10:44.546 --> 00:10:52.100 position:50% align:middle had similar outcomes with clinical reasoning, professional identity values and motivation. 00:10:52.100 --> 00:10:58.120 position:50% align:middle The model did seem successful with the common statewide curriculum taught at all sites. 00:10:58.120 --> 00:11:06.540 position:50% align:middle The ADN students sitting in the same classroom as the ADN/BSN students seemed to benefit from the high level 00:11:06.540 --> 00:11:11.855 position:50% align:middle curriculum meeting both ADN and BSN accreditation standards. 00:11:14.080 --> 00:11:18.270 position:50% align:middle For the implications, we want to continue curriculum integrity. 00:11:18.270 --> 00:11:25.080 position:50% align:middle We want to include good faculty development for new faculty members so that they understand the 00:11:25.080 --> 00:11:30.980 position:50% align:middle NMNEC concept, the NMNEC curriculum, and the NMNEC model. 00:11:30.980 --> 00:11:37.680 position:50% align:middle We want to continue good communication via our webpage, networking, our statewide meetings, 00:11:37.680 --> 00:11:43.700 position:50% align:middle and with our newsletter so that all NMNEC faculty continue to be up to date with NMNEC 00:11:43.700 --> 00:11:45.840 position:50% align:middle changes and updates. 00:11:45.840 --> 00:11:52.480 position:50% align:middle We also want to continue our solid infrastructure with our staff, our NMNEC Leadership Council and 00:11:52.480 --> 00:11:54.592 position:50% align:middle our NMNEC committees. 00:11:56.400 --> 00:11:58.000 position:50% align:middle So, what's next? 00:11:58.000 --> 00:12:01.063 position:50% align:middle We want to continue disseminating our findings. 00:12:02.050 --> 00:12:07.630 position:50% align:middle We think that our model has a lot of value for other states or regions. 00:12:07.630 --> 00:12:13.830 position:50% align:middle We would like to do more evaluative studies, and we want to do more student outcomes research 00:12:13.830 --> 00:12:16.040 position:50% align:middle following entry to practice. 00:12:16.040 --> 00:12:21.690 position:50% align:middle We want to know how do these students do one to two years out, and beyond? 00:12:21.690 --> 00:12:27.652 position:50% align:middle And we'd also like to know what patient outcomes are with this particular model. 00:12:30.260 --> 00:12:35.127 position:50% align:middle These are some of the references that we used with this presentation. 00:12:36.700 --> 00:12:40.063 position:50% align:middle And thank you very much for listening to the presentation. 00:12:59.600 --> 00:13:03.180 position:50% align:middle - Good afternoon, everyone. I'm really pleased to be here with you. 00:13:03.180 --> 00:13:06.460 position:50% align:middle I'll just give you a little bit of update on NMNEC. 00:13:06.460 --> 00:13:08.380 position:50% align:middle We continue to grow. 00:13:08.380 --> 00:13:13.880 position:50% align:middle The University of New Mexico, we alone have six partnering community colleges where 00:13:13.880 --> 00:13:21.430 position:50% align:middle we offer the BSN on the community college campus, and we continue to have really successful results. 00:13:21.430 --> 00:13:25.520 position:50% align:middle It's interesting listening to the previous presentation. 00:13:25.520 --> 00:13:34.530 position:50% align:middle We actually have a study going on that will look at NCLEX and standardized exit testing 00:13:34.530 --> 00:13:43.150 position:50% align:middle scores pre, and during, pandemic teaching strategies and pedagogy. 00:13:43.150 --> 00:13:49.420 position:50% align:middle So, it will be really interesting to see Dr. Osturk's study as well. 00:13:49.420 --> 00:13:54.299 position:50% align:middle And I'm really pleased to take any questions that you might have. 00:14:03.510 --> 00:14:10.160 position:50% align:middle If you don't have any questions at this time, I'm really happy to speak to you by email any time. 00:14:10.160 --> 00:14:23.065 position:50% align:middle My email address is jliesbeld@salud.unm.edu. 00:14:23.065 --> 00:14:27.480 position:50% align:middle Yeah, that's, um...Yeah, your question is very interesting, Beverly. 00:14:27.480 --> 00:14:30.820 position:50% align:middle We didn't really find that they had inferior... 00:14:30.820 --> 00:14:38.070 position:50% align:middle We found that they were actually very similar, because the effect size was so small and insignificant. 00:14:38.070 --> 00:14:43.030 position:50% align:middle Well, that's a great question, to describe NMNEC's relationship with the New Mexico 00:14:43.030 --> 00:14:43.910 position:50% align:middle Board of Nursing. 00:14:43.910 --> 00:14:50.490 position:50% align:middle So, yes, we certainly did have to get approval through the Board of Nursing to do our consortium. 00:14:50.490 --> 00:14:58.510 position:50% align:middle Each school that has the ADN/BSN students, they have their own code 00:14:58.510 --> 00:15:00.820 position:50% align:middle for NCLEX testing. 00:15:00.820 --> 00:15:06.670 position:50% align:middle The Board of Nursing has been incredibly supportive of us. 00:15:06.670 --> 00:15:13.644 position:50% align:middle In fact, they gave us a lot of funding from the Board of Nursing to put this consortium together. 00:15:24.610 --> 00:15:30.240 position:50% align:middle The question about curriculum with the community colleges, not all community colleges belong 00:15:30.240 --> 00:15:32.570 position:50% align:middle to our consortium. 00:15:32.570 --> 00:15:39.260 position:50% align:middle But all of the state funded community colleges do belong to the consortium. 00:15:39.260 --> 00:15:45.122 position:50% align:middle Three of them are just joining in now, and starting with the new curriculum. 00:15:51.350 --> 00:15:53.970 position:50% align:middle Thank you so much for attending my presentation. 00:15:53.970 --> 00:15:57.075 position:50% align:middle It was a pleasure to be with you this afternoon.