WEBVTT 00:00:00.490 --> 00:00:05.380 position:50% align:middle - [Moderator] Nancy Spector is the Director of Regulatory Innovations at NCSBN. 00:00:05.380 --> 00:00:11.930 position:50% align:middle She has worked on a number of initiatives in regulation and education, including social media violations, 00:00:11.930 --> 00:00:18.140 position:50% align:middle trends in nursing education, nursing program approval, distance education, and outcomes and metrics 00:00:18.140 --> 00:00:20.190 position:50% align:middle of nursing education programs. 00:00:20.190 --> 00:00:25.520 position:50% align:middle Dr. Spector presents and publishes nationally and internationally on regulatory issues 00:00:25.520 --> 00:00:27.208 position:50% align:middle in nursing education. 00:00:33.600 --> 00:00:34.990 position:50% align:middle - [Dr. Spector] Good morning, everyone. 00:00:34.990 --> 00:00:40.200 position:50% align:middle It's such a pleasure to be talking to all of you about this very important initiative that we've been working 00:00:40.200 --> 00:00:41.500 position:50% align:middle on it NCSBN. 00:00:41.500 --> 00:00:44.670 position:50% align:middle Of course, I'd much rather talk to all of you in person. 00:00:44.670 --> 00:00:48.050 position:50% align:middle But, the beauty of doing it this way is that more of you can attend. 00:00:48.050 --> 00:00:53.700 position:50% align:middle As you know, there are always players behind the scenes in big projects and that's the case in this one. 00:00:53.700 --> 00:00:59.730 position:50% align:middle So, I especially want to call out Joe Silvestri, Kiana Mackintosh, Greg Mannix, and Brendan Martin, 00:00:59.730 --> 00:01:01.810 position:50% align:middle for all their work and expertise. 00:01:01.810 --> 00:01:05.660 position:50% align:middle But, there are many others as well including Maryanne Alexander, and of course, 00:01:05.660 --> 00:01:10.750 position:50% align:middle this never could have been done without the support from our board of directors. 00:01:10.750 --> 00:01:13.350 position:50% align:middle Here are the objectives for this presentation. 00:01:13.350 --> 00:01:14.870 position:50% align:middle I'll start by setting the stage. 00:01:14.870 --> 00:01:19.660 position:50% align:middle What is the background of this evidence-based core database that we've developed? 00:01:19.660 --> 00:01:25.060 position:50% align:middle Then I'll go question by question to show you the annual report core questions that were supported 00:01:25.060 --> 00:01:26.420 position:50% align:middle by the evidence. 00:01:26.420 --> 00:01:33.590 position:50% align:middle Lastly, I'll talk about next steps and the future of this first-ever nursing education database. 00:01:33.590 --> 00:01:38.960 position:50% align:middle Many of you are aware of the two-year mixed-methods study of nursing education that was published in the 00:01:38.960 --> 00:01:41.670 position:50% align:middle July supplement of JNR. 00:01:41.670 --> 00:01:46.870 position:50% align:middle This study consisted of three national studies and an integrative literature review. 00:01:46.870 --> 00:01:51.910 position:50% align:middle First, we conducted the literature review, leveling the evidence based on the Johns Hopkins 00:01:51.910 --> 00:01:53.450 position:50% align:middle levels of evidence. 00:01:53.450 --> 00:02:01.830 position:50% align:middle Then, we conducted a national Delphi of 295 experts in nursing education regulation and nurses who work 00:02:01.830 --> 00:02:03.400 position:50% align:middle with new graduates. 00:02:03.400 --> 00:02:09.500 position:50% align:middle Next, we conducted a quantitative study of five years of boards of nursing annual reports where 00:02:09.500 --> 00:02:12.220 position:50% align:middle 43 boards participated. 00:02:12.220 --> 00:02:19.790 position:50% align:middle Lastly, we conducted a qualitative study of five years of boards of nursing site visit reports where 31 boards 00:02:19.790 --> 00:02:21.510 position:50% align:middle of nursing provided data. 00:02:21.510 --> 00:02:26.000 position:50% align:middle Now, we didn't think we'd have that high of a response rate for the site visit study, 00:02:26.000 --> 00:02:28.640 position:50% align:middle because not all of the boards conduct site visits. 00:02:28.640 --> 00:02:34.150 position:50% align:middle So, we were very pleased with the response of the boards of nursing for both the site visit study and the 00:02:34.150 --> 00:02:35.550 position:50% align:middle annual report study. 00:02:35.550 --> 00:02:41.790 position:50% align:middle While the annual reports provide quantitative data, like numbers of faculty, clinical hours, etc. 00:02:41.790 --> 00:02:50.380 position:50% align:middle the site visit documents provide rich qualitative data, as they are really the stories of the nursing programs. 00:02:50.380 --> 00:02:56.720 position:50% align:middle In order to be included in the core education database, the questions had to be supported by at least two 00:02:56.720 --> 00:03:02.330 position:50% align:middle of the four areas of the evidence, the three studies, and the integrative literature review. 00:03:02.330 --> 00:03:07.760 position:50% align:middle Additionally, we brought in an expert panel, remember those days when we could all gather, 00:03:07.760 --> 00:03:09.510 position:50% align:middle that reviewed all the evidence. 00:03:09.510 --> 00:03:17.010 position:50% align:middle They consisted of experts in nursing education, the American Association of Colleges of Nursing, NLN, 00:03:17.010 --> 00:03:23.480 position:50% align:middle ODN [SP] were all part of this, as well as research, regulation, and law. 00:03:23.480 --> 00:03:30.390 position:50% align:middle The experts not only brought credibility to the findings but also helped to delineate some issues. 00:03:30.390 --> 00:03:38.150 position:50% align:middle For example, the attorneys brought a fresh perspective to the work, and we did make changes on their advice. 00:03:38.150 --> 00:03:45.120 position:50% align:middle From this research and the regulatory guide, we then developed the core nursing education database. 00:03:45.120 --> 00:03:48.410 position:50% align:middle For boards of nursing that participate, we now have about 20, 00:03:48.410 --> 00:03:55.310 position:50% align:middle we create their annual report based on the core database, and they send the link from Qualtrics 00:03:55.310 --> 00:03:56.770 position:50% align:middle to their programs. 00:03:56.770 --> 00:04:02.860 position:50% align:middle This way, the annual reports will be collected with consistent data among all the boards of nursing. 00:04:02.860 --> 00:04:07.450 position:50% align:middle When we analyze the annual report quantitative study that I mentioned previously, 00:04:07.450 --> 00:04:11.590 position:50% align:middle a limitation was inconsistency of data across boards. 00:04:11.590 --> 00:04:16.870 position:50% align:middle There was missing data and the data were collected in different ways with different timelines. 00:04:16.870 --> 00:04:21.020 position:50% align:middle This database will have the same data being collected in the same way. 00:04:21.020 --> 00:04:26.580 position:50% align:middle This is really a win-win situation for the boards of nursing because we decrease their work by collecting 00:04:26.580 --> 00:04:34.200 position:50% align:middle their annual reports, cleaning the data, for example, one board had 2.5 males in the program, 00:04:34.200 --> 00:04:37.270 position:50% align:middle another average age of students was 1. 00:04:37.270 --> 00:04:44.490 position:50% align:middle So, we had to verify those answers and we answer all faculty questions, and then send the boards a 00:04:44.490 --> 00:04:47.770 position:50% align:middle descriptive report of their programs. 00:04:47.770 --> 00:04:51.140 position:50% align:middle Yet, the boards of nursing can also add their own questions. 00:04:51.140 --> 00:04:55.200 position:50% align:middle We found that some boards of nursing don't add any questions while some have added some 00:04:55.200 --> 00:04:57.500 position:50% align:middle pretty complicated questions. 00:04:57.500 --> 00:05:01.130 position:50% align:middle Here is a snapshot of some of the data that are being collected. 00:05:01.130 --> 00:05:04.020 position:50% align:middle And, remember, this is all evidence based. 00:05:04.020 --> 00:05:10.590 position:50% align:middle For example, national accreditation was found to be significant by three of the four studies. 00:05:10.590 --> 00:05:16.680 position:50% align:middle The program approval status was our dependent variable and certainly an important piece of data. 00:05:16.680 --> 00:05:22.420 position:50% align:middle Geographic location will help us to distinguish if there are any differences in outcomes 00:05:22.420 --> 00:05:23.950 position:50% align:middle based on location. 00:05:23.950 --> 00:05:29.590 position:50% align:middle Year founded, three of our four studies found that the longer-standing programs had better outcomes. 00:05:29.590 --> 00:05:36.290 position:50% align:middle Therefore, on the regulatory guidelines, we call programs younger than seven years high risk. 00:05:36.290 --> 00:05:42.110 position:50% align:middle We ask about satellite sites and program type, as these are more demographic questions. 00:05:42.110 --> 00:05:47.290 position:50% align:middle Our annual report study includes both PN and RN programs. 00:05:47.290 --> 00:05:53.560 position:50% align:middle There is a question about how much online, hybrid, or in-person education the students has, and, 00:05:53.560 --> 00:05:55.750 position:50% align:middle of course, this is pre-pandemic. 00:05:55.750 --> 00:06:02.440 position:50% align:middle As the literature and quantitative study found generally that hybrid programs had better outcomes. 00:06:02.440 --> 00:06:07.910 position:50% align:middle Interestingly, the literature and quantitative study found that semesters had better outcomes. 00:06:07.910 --> 00:06:09.880 position:50% align:middle So, that's another question. 00:06:09.880 --> 00:06:16.230 position:50% align:middle Formal orientation of students was supported by the literature and qualitative study and interestingly, 00:06:16.230 --> 00:06:19.610 position:50% align:middle we are finding that almost all the programs do that. 00:06:19.610 --> 00:06:25.290 position:50% align:middle The literature and qualitative study found that programs have better outcomes when they have resources 00:06:25.290 --> 00:06:29.600 position:50% align:middle for students with English as a second language, and learning disabilities, 00:06:29.600 --> 00:06:34.680 position:50% align:middle as well as services for those to help students who can't afford books or resources. 00:06:34.680 --> 00:06:40.990 position:50% align:middle Some of the low socio-economic students in the poor performing programs in the qualitative study actually 00:06:40.990 --> 00:06:47.960 position:50% align:middle had no books or resources because they couldn't afford them, which was really incredible to us. 00:06:47.960 --> 00:06:53.400 position:50% align:middle The question about remediation goes to, do the programs actually remediate students who 00:06:53.400 --> 00:06:54.790 position:50% align:middle are having trouble? 00:06:54.790 --> 00:07:02.360 position:50% align:middle The progression exams ATI, HESI, for example, are meant for remediation and not simply as cut 00:07:02.360 --> 00:07:03.890 position:50% align:middle scores for students. 00:07:03.890 --> 00:07:08.270 position:50% align:middle This question was supported by the qualitative study and the literature. 00:07:08.270 --> 00:07:15.680 position:50% align:middle Next, what about remediating for errors and near misses in clinical settings and simulation? 00:07:15.680 --> 00:07:18.740 position:50% align:middle This was supported by the literature in the Delphi. 00:07:18.740 --> 00:07:21.760 position:50% align:middle Do the programs keep track of errors and near misses? 00:07:21.760 --> 00:07:25.660 position:50% align:middle Do they use root cause analyses so they can identify the problem? 00:07:25.660 --> 00:07:31.990 position:50% align:middle Sometimes, student errors are the result of system errors or maybe even a lack of nursing education. 00:07:31.990 --> 00:07:35.540 position:50% align:middle We have a great study going on errors and near misses. 00:07:35.540 --> 00:07:40.630 position:50% align:middle The safe student reports study and faculty have networked because of the study, 00:07:40.630 --> 00:07:46.020 position:50% align:middle learning a lot about best practices for teaching drug calculations, using root cause analyses, 00:07:46.020 --> 00:07:48.860 position:50% align:middle developing fair policies, etc.. 00:07:48.860 --> 00:07:51.590 position:50% align:middle Is the program involved in something like that? 00:07:51.590 --> 00:07:53.780 position:50% align:middle What about changes in the program? 00:07:53.780 --> 00:07:59.080 position:50% align:middle And, this was supported by the qualitative study and literature review, like administrator changes, 00:07:59.080 --> 00:08:01.840 position:50% align:middle cuts in faculty, FTEs, etc. 00:08:01.840 --> 00:08:05.340 position:50% align:middle They are predictive of programs falling below standards. 00:08:05.340 --> 00:08:09.770 position:50% align:middle We have seen a lot of these in the annual reports we've reviewed so far. 00:08:09.770 --> 00:08:16.700 position:50% align:middle Simulation, as long as it doesn't go above 50% in each course, and of course, this is during normal times, 00:08:16.700 --> 00:08:21.230 position:50% align:middle is supported by the literature and Delphi and we defined it from the AHRQ 00:08:21.230 --> 00:08:23.490 position:50% align:middle Healthcare Simulation Dictionary. 00:08:23.490 --> 00:08:30.800 position:50% align:middle In fact, many terms throughout the core questions are defined so faculty can know what they're answering. 00:08:30.800 --> 00:08:36.770 position:50% align:middle Simulation faculty being certified and sim centers being accredited, is asked about. 00:08:36.770 --> 00:08:39.660 position:50% align:middle This is a goal programs can reach for. 00:08:39.660 --> 00:08:43.810 position:50% align:middle It was supported by the literature and qualitative study. 00:08:43.810 --> 00:08:50.680 position:50% align:middle Quality clinical experiences with actual patients came out loud and clear on the literature, Delphi, 00:08:50.680 --> 00:08:52.380 position:50% align:middle and qualitative study. 00:08:52.380 --> 00:08:58.420 position:50% align:middle We did not have consistent data on quality clinical experiences from the annual report study but we will 00:08:58.420 --> 00:09:00.330 position:50% align:middle now as we collect these core data. 00:09:00.330 --> 00:09:03.640 position:50% align:middle How many hours do students spend on direct care? 00:09:03.640 --> 00:09:06.220 position:50% align:middle And, of course, this is in normal times. 00:09:06.220 --> 00:09:13.500 position:50% align:middle Unfortunately, in [inaudible] surveys and simulation in 2010, and then repeated in 2017, 00:09:13.500 --> 00:09:18.820 position:50% align:middle we've seen a decrease in numbers of our students spent on direct patient care. 00:09:18.820 --> 00:09:26.840 position:50% align:middle Indeed, in a scoping review of clinical experiences across countries, Hungerford et al found that the U.S. 00:09:26.840 --> 00:09:31.570 position:50% align:middle lags behind the UK, Australia, New Zealand in numbers of clinical hours that 00:09:31.570 --> 00:09:34.090 position:50% align:middle pre-licensure student nurses must have. 00:09:34.090 --> 00:09:39.810 position:50% align:middle As we collect these annual report data, we may find some answers for the minimum number 00:09:39.810 --> 00:09:43.170 position:50% align:middle of hours that pre-licensure programs should require. 00:09:43.170 --> 00:09:47.180 position:50% align:middle Similarly, we ask about simulation and skills hours. 00:09:47.180 --> 00:09:50.340 position:50% align:middle And, of course, this is in pre-pandemic times. 00:09:50.340 --> 00:09:57.240 position:50% align:middle These are both very important teaching strategies, again, supported by the Delphi and the literature. 00:09:57.240 --> 00:10:03.040 position:50% align:middle We found from the literature and quantitative study that the director of an RN program should have a 00:10:03.040 --> 00:10:07.090 position:50% align:middle doctoral degree and a graduate degree for a PN program. 00:10:07.090 --> 00:10:10.490 position:50% align:middle And, there was also support for the program director being a nurse. 00:10:10.490 --> 00:10:14.070 position:50% align:middle So, we ask those questions on the core annual report survey. 00:10:14.070 --> 00:10:19.340 position:50% align:middle An interesting finding was that if the director is also in charge of the Allied program, 00:10:19.340 --> 00:10:25.170 position:50% align:middle there needs to be an assistant or an associate director to take care of those day-to-day activities 00:10:25.170 --> 00:10:27.110 position:50% align:middle in the nursing programs. 00:10:27.110 --> 00:10:30.770 position:50% align:middle Similarly, there needs to be dedicated administrative help. 00:10:30.770 --> 00:10:34.930 position:50% align:middle This was supported by the qualitative study in the literature. 00:10:34.930 --> 00:10:41.800 position:50% align:middle Our studies confirmed what we already know, faculty are the bedrock of nursing education, 00:10:41.800 --> 00:10:44.120 position:50% align:middle so there are lots of questions on that. 00:10:44.120 --> 00:10:50.700 position:50% align:middle We ask about the percentage of full-time faculty with a denominator including all part-time, adjunct, 00:10:50.700 --> 00:10:52.480 position:50% align:middle and full-time faculty. 00:10:52.480 --> 00:10:58.020 position:50% align:middle Our studies found that fewer than 35% full-time faculty predict poorer outcomes. 00:10:58.020 --> 00:11:00.560 position:50% align:middle This was supported by all four studies. 00:11:00.560 --> 00:11:03.330 position:50% align:middle Now, you might think 35% is a little low. 00:11:03.330 --> 00:11:04.690 position:50% align:middle I certainly do. 00:11:04.690 --> 00:11:09.010 position:50% align:middle We'll find out as we collect more consistent data among the boards. 00:11:09.010 --> 00:11:14.560 position:50% align:middle Yet, we have found from the annual reports we have collected so far, that some schools have a lot 00:11:14.560 --> 00:11:18.080 position:50% align:middle of adjunct faculty and very few full-time faculty. 00:11:18.080 --> 00:11:24.330 position:50% align:middle So, we'll see in the aggregate analysis that is collected this summer what that average is and if a 00:11:24.330 --> 00:11:28.600 position:50% align:middle higher percent of full-time faculty does predict better outcomes. 00:11:28.600 --> 00:11:36.240 position:50% align:middle We also ask about faculty credentials as our studies found better outcomes when faculty in RN programs hold 00:11:36.240 --> 00:11:40.410 position:50% align:middle graduate degrees and in PN programs BSN degrees. 00:11:40.410 --> 00:11:47.230 position:50% align:middle The faculty ratio in clinical and didactic courses does not have a lot of evidence but this is a question that 00:11:47.230 --> 00:11:51.240 position:50% align:middle comes up a lot to boards of nursing, so we need more data. 00:11:51.240 --> 00:11:59.040 position:50% align:middle Interestingly, Odom-Maryon in 2018, found higher NCLEX pass rates linked to higher 00:11:59.040 --> 00:12:04.430 position:50% align:middle student-faculty didactic ratios, which is a bit counterintuitive so we'll see 00:12:04.430 --> 00:12:05.940 position:50% align:middle what we find. 00:12:05.940 --> 00:12:12.470 position:50% align:middle Our qualitative and Delphi studies and literature support orientation of adjunct faculty, 00:12:12.470 --> 00:12:19.140 position:50% align:middle as oftentimes they are clinicians who have no idea of the curriculum or even what the students are learning 00:12:19.140 --> 00:12:22.000 position:50% align:middle in their companion clinical course. 00:12:22.000 --> 00:12:26.590 position:50% align:middle While in the previous slide, we talked about the importance of orientation 00:12:26.590 --> 00:12:28.400 position:50% align:middle of adjunct faculty, 00:12:28.400 --> 00:12:34.330 position:50% align:middle orientation of all faculty came out loud and clear in our studies, and is included in the core 00:12:34.330 --> 00:12:36.000 position:50% align:middle data annual report. 00:12:36.000 --> 00:12:41.550 position:50% align:middle We found that many times faculty come from clinical positions such as DNPs and just aren't prepared 00:12:41.550 --> 00:12:44.260 position:50% align:middle to teach for full-time faculty. 00:12:44.260 --> 00:12:49.240 position:50% align:middle The study supported a year of mentorship with a seasoned faculty member. 00:12:49.240 --> 00:12:51.270 position:50% align:middle So, this is another question. 00:12:51.270 --> 00:12:56.790 position:50% align:middle Additionally, our studies found that faculty should have some professional development in the areas 00:12:56.790 --> 00:13:02.460 position:50% align:middle of adult learning and curriculum development and this will be asked on future surveys. 00:13:02.460 --> 00:13:06.480 position:50% align:middle In the left column are some of the questions related to demographics. 00:13:06.480 --> 00:13:12.330 position:50% align:middle It is important on surveys like this to be very specific when asking questions so that we can 00:13:12.330 --> 00:13:14.160 position:50% align:middle collect consistent data. 00:13:14.160 --> 00:13:19.320 position:50% align:middle We asked about the enrollment data in the beginning of the 2021 academic year. 00:13:19.320 --> 00:13:23.960 position:50% align:middle And even though that is pretty specific, we still got questions from faculty who wanted to be 00:13:23.960 --> 00:13:26.380 position:50% align:middle sure they were answering accurately. 00:13:26.380 --> 00:13:31.980 position:50% align:middle We asked about maximum enrollment, and then the average age of the students. 00:13:31.980 --> 00:13:34.330 position:50% align:middle Attrition questions were harder to develop. 00:13:34.330 --> 00:13:40.260 position:50% align:middle We went to the U.S. Department of Education as well as other places, but finally ended up specifically asking 00:13:40.260 --> 00:13:45.830 position:50% align:middle about the last graduating cohort, the number who started, the number who graduated, 00:13:45.830 --> 00:13:48.490 position:50% align:middle and the number who are still pursuing coursework. 00:13:48.490 --> 00:13:55.060 position:50% align:middle We realize this is a snapshot in time about attrition but it seemed to be the most reliable way to ask 00:13:55.060 --> 00:13:58.630 position:50% align:middle the question, and we'll see what we find in the analysis. 00:13:58.630 --> 00:14:03.250 position:50% align:middle Depending on that, we could change how those questions are asked. 00:14:03.250 --> 00:14:08.790 position:50% align:middle There was a lot in the literature about attrition, though it did not come up in any of our studies. 00:14:08.790 --> 00:14:14.650 position:50% align:middle We still thought it needed to be asked because many boards of nursing and the accreditors consider this 00:14:14.650 --> 00:14:17.140 position:50% align:middle to be an important outcome. 00:14:17.140 --> 00:14:22.800 position:50% align:middle Especially in the literature and the site visit study, we learned about minority students not having enough 00:14:22.800 --> 00:14:26.260 position:50% align:middle support, so this is an important question. 00:14:26.260 --> 00:14:30.905 position:50% align:middle The sex of students is really more demographic. 00:14:30.905 --> 00:14:36.319 position:50% align:middle These were the core questions and as you can see, they are evidence based. 00:14:36.319 --> 00:14:43.030 position:50% align:middle There are only 52 core questions which many programs liked, as they were used to a lot more questions. 00:14:43.030 --> 00:14:49.410 position:50% align:middle Since ours is a core data survey, every question had to have a reason for asking it and the respondents 00:14:49.410 --> 00:14:53.480 position:50% align:middle couldn't go forward until they answered every question. 00:14:53.480 --> 00:14:59.450 position:50% align:middle Then, however, the boards of nursing can add as many additional questions as they like, as I've said. 00:14:59.450 --> 00:15:05.620 position:50% align:middle We also took this opportunity to ask about the impact of COVID-19 on nursing programs. 00:15:05.620 --> 00:15:08.130 position:50% align:middle We have 16 questions on that. 00:15:08.130 --> 00:15:15.310 position:50% align:middle To date, it is almost unanimous that the pandemic had a major disruption on nursing programs. 00:15:15.310 --> 00:15:21.940 position:50% align:middle We've been able to create a National Nursing Database because of the consistency of data being collected 00:15:21.940 --> 00:15:24.370 position:50% align:middle which is all based on the evidence. 00:15:24.370 --> 00:15:29.920 position:50% align:middle This will allow our research team to do more sophisticated statistical analyses 00:15:29.920 --> 00:15:31.990 position:50% align:middle on the aggregate data. 00:15:31.990 --> 00:15:38.960 position:50% align:middle NRBs will be able to compare data across jurisdictions and the programs will be able to benchmark their 00:15:38.960 --> 00:15:40.220 position:50% align:middle data as well. 00:15:40.220 --> 00:15:48.130 position:50% align:middle This could be helpful for administration getting funds for accreditation, resources, more faculty, etc. 00:15:48.130 --> 00:15:54.310 position:50% align:middle For this first year of rolling this out we have about 20 boards of nursing who are participating. 00:15:54.310 --> 00:15:59.000 position:50% align:middle That is excellent but, of course, our goal is for all boards of nursing to participate. 00:15:59.000 --> 00:16:02.980 position:50% align:middle We'll be hosting a webinar in this spring to recruit more boards of nursing. 00:16:02.980 --> 00:16:08.790 position:50% align:middle So far, we've had a positive feedback from all of the boards of nursing who have participated. 00:16:08.790 --> 00:16:14.280 position:50% align:middle In the summer, then, Dr. Martin and his research team will analyze all the aggregate data for the core 00:16:14.280 --> 00:16:20.260 position:50% align:middle questions and we'll update the regulatory guidelines as necessary based on any new data. 00:16:20.260 --> 00:16:26.450 position:50% align:middle For example, right now we have found that 35% of full-time faculty are a quality indicator. 00:16:26.450 --> 00:16:29.390 position:50% align:middle Will this percentage change when we have more data? 00:16:29.390 --> 00:16:34.340 position:50% align:middle Additionally, there is no evidence to support a minimum number of clinical hours required 00:16:34.340 --> 00:16:36.040 position:50% align:middle for pre-licensure students. 00:16:36.040 --> 00:16:39.390 position:50% align:middle Will this change with more consistent data? 00:16:39.390 --> 00:16:46.690 position:50% align:middle Then, we'll also analyze COVID-19 questions this summer to determine the impact on nursing education. 00:16:46.690 --> 00:16:51.290 position:50% align:middle From what we've seen so far there's been quite an impact as I've said. 00:16:51.290 --> 00:16:56.450 position:50% align:middle While many programs have said that their learning outcomes have been about the same fair number has said 00:16:56.450 --> 00:16:58.030 position:50% align:middle that their outcomes have been worse. 00:16:58.030 --> 00:17:04.400 position:50% align:middle And, of course, we'll publish our aggregated results of the COVID-19 questions. 00:17:04.400 --> 00:17:09.980 position:50% align:middle We are really excited about our first-ever nursing education database. 00:17:09.980 --> 00:17:16.540 position:50% align:middle Both the NRBs and the nursing education programs will be able to use the benchmarks we have developed. 00:17:16.540 --> 00:17:23.850 position:50% align:middle Right now, many boards of nursing are using these benchmarks when approving nursing education programs. 00:17:23.850 --> 00:17:30.870 position:50% align:middle We know it has been a very hard year for making any big changes, so a big thank you to all of the boards 00:17:30.870 --> 00:17:35.190 position:50% align:middle of nursing that are participating in this annual report project now. 00:17:35.190 --> 00:17:42.130 position:50% align:middle And, we hope as this year gets better and it will, more will be able to participate next year. 00:17:42.130 --> 00:17:48.140 position:50% align:middle Some of our associate NRBs have expressed interest in participating in this project. 00:17:48.140 --> 00:17:54.340 position:50% align:middle Once we have more of a system developed we would definitely like to include international regulatory 00:17:54.340 --> 00:18:00.460 position:50% align:middle bodies in this project and start a global nursing education database. 00:18:00.460 --> 00:18:06.290 position:50% align:middle Currently, we have been very busy establishing a process that works for all the boards of nursing 00:18:06.290 --> 00:18:07.390 position:50% align:middle in the U.S. 00:18:07.390 --> 00:18:13.760 position:50% align:middle So, we probably need to get that process established first, but it is exciting thinking about extending 00:18:13.760 --> 00:18:15.950 position:50% align:middle this project internationally. 00:18:15.950 --> 00:18:23.010 position:50% align:middle Of course, we will publish the aggregate findings and update our regulatory guidelines as appropriate. 00:18:23.010 --> 00:18:28.740 position:50% align:middle I always like to end with a quote and I love this quote from Florence Nightingale and some of you've probably 00:18:28.740 --> 00:18:32.920 position:50% align:middle heard it before from me, "Were there none who are discontented with what 00:18:32.920 --> 00:18:36.850 position:50% align:middle they have, the world would never reach anything better." 00:18:36.850 --> 00:18:38.350 position:50% align:middle Isn't that true? 00:18:38.350 --> 00:18:44.320 position:50% align:middle The nursing regulatory bodies wanted more evidence for program approval and from that work, 00:18:44.320 --> 00:18:51.440 position:50% align:middle we've been able to develop the first-ever evidence-based core nursing education database. 00:18:51.440 --> 00:18:53.630 position:50% align:middle Thanks so much for your attention. 00:18:53.630 --> 00:18:55.610 position:50% align:middle Now, we'll have a live Q&A. 00:18:55.610 --> 00:18:59.401 position:50% align:middle You can enter your questions into the Q&A box.