Byrdine F. Lewis School of Nursing Academic Program Review Self-Study

Review Period: 2002-2005

A. Unit Assessment of Strengths and Weaknesses

Quality of Instruction, Research, & Service: The quality of instruction in the Byrdine F. Lewis School of Nursing (BFLSON) is very good. We have expert clinicians and teachers instructing our students at all program levels. Indicators that support the quality of our instruction include outcomes such as improved first time pass rates on the NCLEX licensure examination by undergraduate (UG) students, advanced practice nursing certification rates of greater than 90% by our master’s students, faculty research and scholarly productivity, and leadership positions held by faculty and alumni in the community.

One area for improvement is related to our teaching performance. An overview of individual instructor evaluations for nursing courses indicates that current student satisfaction with instruction is good to very good; however, student and alumni reports via the OIR (see Section D. Curriculum Quality), indicate that the quality of instruction related to the preparedness and class presentations of some faculty is of concern. Our aim is foster teaching excellence, thus we will continue to sponsor educational opportunities for faculty development in teaching, encourage new faculty members to attend professional development workshops to improve the quality of instruction, and mentor new nurse educators in the art of instruction.

We are pleased with the increase in research and scholarly productivity in the BFLSON (see Table B-2 and discussion in Section B. Current Context), yet there is room for improvement. We are excited about the initiatives we have implemented to support research and scholarly productivity. In the last 2 years two tenure track faculty members with research expertise and who have obtained federal funding have joined the faculty. In addition, a faculty member with expertise in statistics has joined the faculty part-time. Measures are in place to support the research development of new doctoral-prepared faculty and the productivity of senior faculty (e.g. consultation with a research consultant, support for a mock grant review, faculty release time, development of a research interest group). A mentorship program for new doctoral-prepared faculty was instituted two years ago. The challenge is a time issue for faculty: increasing research and scholarly productivity while managing teaching workloads. The amount of external funding is acceptable, yet an increase in grants, particularly at the federal level is desired. The opportunity for promotion of our non-tenured track (NTT) faculty is now available and includes the expectation of scholarly productivity through publication. With this new expectation for publication to obtain NTT promotion, the BFLSON will need to develop support systems to assist NTT faculty in meeting this criterion. We have a research and scholarly productivity interest group that is lead by an expert nurse researcher consultant and that supports grant writing and publication. However, a mentorship program for NTT faculty seeking promotion would likely increase their scholarly productivity while supporting promotion.

Faculty service to the BFLSON, College of Health and Human Sciences (CHHS), the University, the greater Atlanta area and professional nursing is exceptional. Faculty members serve on an average of two committees in the BFLSON. Many serve on College committees and on the Senate and Senate sub-committees. As noted in Appendix F5, faculty members are involved in professional nursing organizations, serving on national, state, and regional boards and committees. Faculty service to the greater Atlanta community ranges from volunteer clinical practice to service as members of community boards and committees. In addition, the BFLSON Health and Wellness Collaborative

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serves the community by conducting back-to-school physicals for underserved children, providing flu shots to state employees, and offering other health screening activities. Faculty service to the community is varied and extensive.

Centrality of Programs to University: The BFLSON contributes to the mission of the University through the successes of its graduates who “contribute to the economic, educational, social, professional, and cultural vitality of the city, the state, and the region.” Nursing students and graduates address social and human welfare issues and promote innovation in health care. Similarly “the mission of the College of Health and Human Sciences is to engage in teaching, scholarly endeavors, and service activities that improve health and well-being and address social justice issues within a multi-cultural society.” Faculty members in the BLFSON teach students in the art and science of nursing, are engaged in a wide range of scholarly activities, and are involved in service activities within the University and the community. In addition the BFLSON meets a key need in the state of Georgia. With the current nursing shortage that is expected to leave Georgia with a 23% nursing shortage in 2010, graduates of our programs make significant contributions to the health and welfare of Georgia citizens. In summary, the BFLSON makes significant contributions to the University, to Atlanta’s health care community, and to the citizens of Georgia.

Viability of Programs: The undergraduate (UG), master’s (MS), and doctoral (PhD) programs in the BLFSON are viable. Admissions to the UG program have doubled in three years since the initiation of the accelerated program. The number of UG graduates has increased from 61 per year in Spring 2003 to 104 per year in Spring 2005; see discussion in Section B and Table B-3. Applications for admission range between 400 – 800 applicants per year; many qualified applicants are denied admission due to lack of faculty and clinical resources. Managing the costs for the UG clinical nursing courses is challenging from the perspective of the expense of hiring part-time clinical instructors who are necessary to meet state and agency regulations that dictate clinical instructor to student ratios in clinical agencies; see Section B, Current Context. In summary, the UG program is viable with increased enrollments and graduations and improved student outcomes (higher first time NCLEX pass rates), however, the expense of part-time clinical instructors is a significant resource issue.

Consistent with the BFLSON mission of a focus on graduate education, enrollment in the master’s program is also strong and has increased steadily over the last three years, ranging from 176 students enrolled in the MS program in 2003 to 246 students enrolled in 2005. The number of MS graduates over the last three years has averaged 86 graduates per year; see Table B-3. We are pleased that our graduates have a very high rate of certification and are employed in advanced practice nurse (APN) roles; see Section B, Indication of Program Relevance. However, two resource issues prevail. Although the availability of certified advanced practice nurses at the doctoral level is limited, we have a strong cadre of master’s prepared advanced practice nurses who teach in specialty courses. The limited availability of doctoral-prepared clinical nurse specialists (CNS) and nurse practitioners (NP) in specialty areas restricts our ability to increase the tenure/tenure track (T/TT) to NTT faculty ratio. In addition, with the increased enrollment in the master’s courses and greater restrictions regarding MS trainees in clinical sites, recruiting qualified advanced practice nurses and physicians to serve as preceptors can be challenging and has limited enrollment in one of the specialty tracks (Family Nurse Practitioner [FNP]). In summary, student enrollment and graduations indicate that the MS program is viable. The two resource issues are continually being addressed.

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The number of students in the PhD program has remained steady over the last three years, averaging 27.6 students per year. Annual graduations average three per year. See Table B-1. These numbers reflect the attempt by the BFLSON to decrease the number of doctoral students as recommended by the Academic Program Review Committee (APRC) at the time of the 1993 review (n = 50). The quality issue associated with the PhD students is related to GRE scores. Over the last three years, the mean total score by matriculated students for the verbal and quantitative sections was 965; mean verbal score = 493; mean quantitative score = 471; see Table E-1b and discussion in Section E. The GRE website reports that the general test percentage distribution of scores within nursing based on seniors and non-enrolled college graduates for verbal and quantitative performance are as follows: verbal—mean = 454; quantitative—mean = 519. Our average student admission verbal score exceeds that reported by GRE, while our quantitative mean score falls considerably below that reported by GRE. A potential explanation for lower quantitative GRE scores is the fact that our PhD applicants apply for doctoral education approximately 15-20 years post-baccalaureate degree. The time lapse of many years between completion of the baccalaureate degree and exposure to formal mathematics courses and application to the PhD program likely contributes to lower performance on the GRE. However, our experience with PhD students indicates that students with lower quantitative scores can be successful in the program, particularly those who have research interests consistent with their faculty mentors.

From a resource perspective, we have recently employed three faculty members who are seasoned researchers, one of which is a statistician. Their expertise enhances our program and will allow some expansion of the PhD program with additional faculty to serve as committee chairs. In summary, enrollments and graduations from the PhD program support its viability. Although GRE scores are less than optimal, student success has been excellent.

Strategic Focus: Our strategic focus is on excellence in our nursing programs. The critical nursing shortage will plague health care in the United States for decades to come. Our nursing programs produce nurses who lessen the impact of that shortage in Georgia. In the last 3-4 years, our UG program has undergone many changes that have enhanced student outcomes in regards to ERI Exit Examination and NCLEX performance. With a strong program in place, we were able to offer an accelerated program to qualified students who could successfully complete the BS in nursing in four semesters. We have succeeded in almost doubling the number of nursing graduates per year with the implementation of this new track. From student application numbers for RN licensure in Georgia, we estimate that about 90% of our new graduates accept nursing positions in Georgia, making a significant contribution to health care in Georgia.

At the master’s level, we offer a MS degree with the option of choosing one of five specialty tracks (adult health clinical nurse specialist [AHN CNS], women health nurse practitioner/clinical nurse specialist [WHNP/CNS], pediatric nurse practitioner/clinical nurse specialist [PNP/CNS], psychiatric mental health clinical nurse specialist [PMH CNS], and family nurse practitioner [FNP]. The rationale for choosing these specialty areas was based on the need for advanced practice nurses that could function in primary care (e.g. clinics, health departments, etc.) or acute care (e.g. hospitals, etc.) settings. Advanced practice nurses offer cost-effective alternatives to physicians; these nurses can manage common health complaints and chronic illness seen in primary care or they can direct the care of patients with multiple and complex health care needs. Our graduates practice in both acute and primary care settings throughout Georgia and in many cases provide their services to the underserved.

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The shortage of doctoral-prepared faculty in nursing mirrors the shortage of nurses in patient care positions. The BLFSON provides a strong research base in the PhD program that prepares nurses to conduct research that adds to the body of knowledge in nursing and health care. In addition, many of these graduates are employed in academic institutions. Of the 28 PhD graduates from 2000 to 2005, we were able to determine that 18 out of 20 (90%) are employed in academic institutions, 12 (60%) of these graduates are employed in Georgia institutions. Thus the BFLSON helps to meet the demand for qualified PhD prepared faculty.

Financial Resource Analysis: The School has received small budgetary increases during FY 2002, 2003, and 2004; a budget reduction was experienced in FY 2005 due to a one-time give back to the university; see Table A-1 and Appendix G3. Supplies remained stable until FY 2005 when a $5,000 increase was received. The travel budget has remained the same over the last four years. The BFLSON has been able to greatly increase credit hours during this period of time due to additional funding from ICAPP and Tenet to support the accelerated BS program. Tenet and ICAPP funds have supported three new FT faculty positions and have provided additional funds for part-time instructor (PTI) expenses. When the ICAPP and Tenet funds expire in 2006, the school will not be able to maintain this level of credit hour production without additional financial resources. In addition we have two faculty members funded by Tenet and will lose funding for these positions in Spring 2006. Although we have been very pleased with the increased enrollments, faculty scholarly productivity has been negatively influenced by heavy teaching assignments created by increased enrollment. Another critical issue related to financing the UG program is the cost for part-time clinical instructors (PTIs) who supervise students in clinical sites. Budget allowances for PTI costs are insufficient to cover the total cost for PTI services. See discussion in Section G. Resource Adequacy, Faculty Resources.

Table A-1. Byrdine F. Lewis School of Nursing Budget Summary FY 2002-2005 FY 2002 FY 2003 FY 2004 FY 2005

Personal $2,455,516 $2,491,555 $2,565,934 $2,550,558 Supplies $100,973 $100,973 $100,973 $105,973 Travel $23,000 $23,000 $23,000 $23,000

Total $2,679,531 $2,694,907 $2,620,528 $2,579,489

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B. Historical and Current Contexts

Historical Context: The Department of Nursing was established in 1968 and offered an associate degree in nursing and a RN completion program (RN-BS). In 1973-1974, the masters program (MS) was initiated with multiple nursing specialty tracks approved including the AHN CNS, WHNP/CNS, PNP/CNS, PMH CNS, and FNP. In 1979 the associate degree program was eliminated and a generic baccalaureate nursing program (BS) was offered. By 1981 the Department of Nursing became the School of Nursing. The doctoral program (PhD) in nursing began in 1986 and has graduated 86 students as of Summer 2005. Due to the nursing shortage and the demand for enrollment in nursing programs, the BS accelerated track was initiated in Fall 2002. In 2003 the School of Nursing was renamed the Byrdine F. Lewis School of Nursing (BFLSON) following a generous donation by a benefactor.

Current Context: Current context is presented for academic years 2002-03, 2003-04, and 2004-05. Currently, the BFLSON includes the Director, Associate Director for the Graduate Program, Associate Director for the Undergraduate Program, 31 full-time faculty (including Dr. Susan Kelley, Dean, CHHS), a business manager, and eight staff. Table B-1 displays a summary of the information on the rank, tenure status and minority status of faculty and Appendices B-4 shows the current faculty roster and summary tables. On the average for the three years, the faculty consisted of 30.6 full-time faculty, including Dean Kelley. Of these, tenured/tenure-track positions averaged 15.0 (45 T/TT/3 years) while non-tenure track positions averaged 15.7 (47 NTT/3) positions. During this time UG enrollment doubled with the initiation of the accelerated track, increasing from about 50 admissions per year to a current average of 110 per year. Monies from ICAPP and Tenet grants helped us manage the increased workload with a relatively stable faculty and the use of part-time clinical instructors. One benchmark school of nursing (SON), the University of Tennessee (UTN) at Knoxville reported a similar number of UG students (N = 249) and a smaller number of MS and PhD students. UTN reported a full-time faculty complement of 44 faculty, 10 more than we have in the BFFSON; see Appendix B6-a.

Table B-1 Faculty Distribution for FY 2002-2004 Tenure Tenure Track Non Tenure Track Total^

Year Status Prof. Assoc. Assoc. Asst. Clin. Assoc

Clin. Asst.

Clin Instr. (FT)

Acad Prof*

Clin Instr.**

(PT) F 02-03 3 8 2 2 2 8 2 3 0 30

Female 3 8 2 2 2 8 2 3 0 30 Minority 0 0 0 0 0 1 0 1 0 3

Tenure Tenure Track Non Tenure Track Total^ Year Status Prof. Assoc. Assoc. Asst. Clin. Clin. Clin Acad Clin

Assoc Asst. Instr. Prof* Instr.** (FT) (PT)

F 03-04 3 9 0 2 2 8 2 2 0 28 Female 3 9 0 2 2 8 2 2 0 28 Minority 0 1 0 0 0 1 0 1 0 3

F 04-05 4 8 1 3 2 9 5 2 0 34 Female 4 8 1 3 2 9 5 2 0 34 Minority 0 1 0 0 0 1 1 1 0 4

Average 3 8.3 1 2.3 2 8.3 3 2.3 N/A 30.6

* Academic Professional ** Part-time Clinical Instructors (PTIS) are not included in this table; see discussion in text.

On average 20 part-time clinical instructors (PTIs) supervise students in approximately 27 clinical rotations per semester during Fall and Spring semesters and 13 PTIs provide clinical teaching services in the summer semester. These PTIs are not considered part of the regular faculty complement. In a clinical course, 1 to

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7 PTIs may be hired; they supervise 6-8 students in the clinical setting. To assure patient safety, small group supervision is regulated by the Georgia State Board of Nursing and to some degree by clinical agencies that can only accommodate a specified number of students within a clinical unit. The course administrator (full-time faculty member) for the course oversees the PTIs. Hiring of the PTIs is done on a semester basis by the Associate Director for the Undergraduate Programs in conjunction with the faculty teaching in the course. Each PTI is paid approximately $4200 per clinical rotation (i.e. 12 hours/week x 7 weeks). The cost of these PTIs is a drain on the BFLSON budget, as they do not directly generate credit hours. During Fall 2004, Spring 2005, and Summer 2005, 52 PTIs covered 65 clinical rotations at the cost of $274,700. With the addition of new full-time faculty we expect these costs to drop slightly, however, projected costs for PTIs in Fall 2005 is $96,000 (17 PTIs covering 23 clinical rotations). The expert clinical PTIs are essential for keeping enrollment numbers stable. They are a more cost-effective and practical alternative to hiring full-time faculty for clinical rotations. The numbers and cost of FT faculty to meet the needs for clinical instructors for UG students would be exorbitant. Our utilization

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of PTIs is considerably higher than that reported by two of our benchmarking institutions (University of South Carolina [USC], UTN, and University of South Florida [USF]; see Appendix B6-a (summary data) and Appendix B6-b (raw data). However, we have a smaller number of full-time faculty, thus more part-time master’s prepared clinical instructors (PTIs) are essential to provide quality clinical experiences within established safety guidelines.

As can be seen in the organization chart (Appendix B2), the associate directors, faculty, and business manager report directly to the Director. The staff reports to the business manager. By-laws (Appendix B3) provide direction for the functioning of the unit. In response to the APRC recommendations (1998), the department organizational structure was replaced with a committee structure; see Appendix C4. This change has proved to be beneficial.

Faculty Productivity: Faculty productivity has been increasing over the last three years; see Table B-2 (summary) and Appendix B7 for individual faculty productivity. The average number of publications (n=17) by the average number of all full-time faculty (n = 30.6) over 3 years is 0.55 publications per faculty per year. Until last year NTT faculty members were not expected to publish to attain promotion, however 2 refereed articles were published by faculty of this rank. The average number of refereed publications (n=49/3=16.3) by the average number of T/TT faculty (n=15) is 1.08 publications per T/TT faculty per year. Publication of refereed articles and other scholarly works and conference presentations have increased considerably in the last three years, averaging 17 referred articles, 50 presentations, and 16 other publications per year. Our expectation is that our productivity will continue to increase, especially now that our NTT faculty will put energies into these activities to attain promotion. The annual mean for external and internal funding is $4,291,930 and $207,498, respectively. We anticipate that both internal and external funding increase in the next few years as the number of T/TT faculty increases.

Table B-2 Faculty Productivity Summary for AY 2003-2005

Year Referred Publications

Scholarly Works*

External Funding

Internal Funding

Presentations** Other Publications**

2003 16 4 $5,906,735 $293,079 55 14 2004 13 7 $1,401,964 $42,087 41 17 2005 22 12 $5,567,091 $287,328 55 18 Total 51 23 $12,875,790 $622,494 151 49

Yearly Average 17 7.7 $4,291,930 $207,498 50.3 16.3

* Books, chapters, dissertations, monographs ** Conference presentations, posters *** Other: newsletters, editorials, abstracts, radio spots, Internet

BFLSON Programs: Currently the BFLSON offers a BS with a major in nursing (traditional and accelerated tracks), a RN-BS completion program, a masters program with five specialty tracks (AHN CNS, PNP/CNS, WHNP/CNS, FNP, PMH CNS), a RN-MS program, and a PhD program; see Table B-3. Certificates are offered in each of the master’s specialty areas. Student enrollment has increased in the BS and MS programs and been relatively stable in the PhD program. Enrollment in the BS program has doubled since the initiation of the accelerated track. Enrollment for the master’s certificate programs is relatively low, however, these programs do not demand extra resources as the courses required for certification are offered regularly in the specialty tracks and the few certification students can be easily accommodated.

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Table B-3 Program Types by Majors and Specialties and Number of Major Students and Graduates 2003-2005 Program Major Concentration 2003 2004 2005 3 Year Average

Majors Graduates Majors Graduates Majors

Graduates Majors Graduates

B.S. Nurs Generic 226 56 276 86 285 100 262.3 80.7 RN-BS 14 5 11 7 9 4 11.3 5.3

Total 240 61 287 93 294 104 273.6 86.0 M.S. Nurs AHN CNS 19 4 20 4 36 2 25.0 3.33

CHCNS/PNP 29 10 38 10 45 16 37.3 12.0 FNP 105 26 106 30 115 26 108.6 27.33 PMH CNS 9 1 16 5 17 2 14.0 2.67 PWHCNSNP 14 4 28 5 33 7 25.0 5.33

Total 176 45 208 54 246 53 209.9 50.66 PhD Nurs Health Prom 27 4 28 2 28 3 27.6 3.0

Total 27 0 28 3 28 4 27.6 3.0 Cert. Nurs CHCNS/PNP 0 0 1 0 1 0 0.67 0

FNP 1 1 0 0 4 0 1.6 0 PMH CNS 0 0 0 0 0 0 0 0 PWHCNSNP 0 0 2 1 1 0 1.0 0.33

Total 1 1 3 1 5 0

Note: The number presented for majors in a year for the baccalaureate program does not include the number of pre-nursing majors. The numbers for the RN-MS track are incorporated into the specialty track numbers.

Credit Hours: Credit hour generation has increased as enrollment has increased. Tables B-4a, B-4b, and B-4c present credit hours by faculty rank. In Appendices B4-a, B4-b, and B4-c individual faculty credit hour generation is reported by year. The total number of credit hours generated for academic years 2002-2005 are 9,908, 10,954, and 11,375 respectively, for a total of 32,237 credit hours. Table B-4d shows the average credit hour generation and percentage of credit hours taught by faculty rank. Tenured/tenure track (T/TT) faculty account for 33% of credit hour generation with UG students and 68.4% of the credit hours generated by graduate courses. NTT faculty members teach 66.7% of the UG credit hours and 31.6% of the graduate credit hours. For clarification, masters-prepared faculty members with certification in their specialty are required to teach students in their specific masters specialty tracks. Although doctoral-prepared faculty with specialty preparation would be optimal, these faculty are difficult to locate and recruit. Only doctoral-prepared faculty teach in the PhD program.

Table B-4a FY2002-2003 Credit Hours Taught by Nursing Faculty By Level and Faculty Type*

Faculty Type UG Core (HHS & PERS Courses)

UG Lower Division (2000 Courses)

UG Upper Division (3000-4000

Courses)

Graduate

Tenured/Tenure Track (n = 15) 973 675.5 192 1971.75 Non-Tenured (n = 15) 1095 1570.5 2497 933.25 Total (n=30) 2068 2246 2689 2905

* PTIs are generally clinical instructors who supervise 6-8 students in a clinical rotation. A clinical course can include 1-7 PTIs in addition to the Course Administrator (CA) and full-time faculty. For the sake of clarity, credit hour generation is assigned to the CA.

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Table B-4b FY2003-2004 Credit Hours Taught by Nursing Faculty By Level and Faculty Type*

Faculty Type UG Core (HHS & PERS Courses)

UG Lower Division (2000 Courses)

UG Upper Division (3000-4000

Courses)

Graduate

Tenured/Tenure Track (n = 14) 1354 828 756 1853.5 Non-Tenured (n = 14) 939 1844 2861 518.5 Total (n = 28) 2293 2672 3617 2372

* PTIs are generally clinical instructors who supervise 6-8 students in a clinical rotation. A clinical course can include 1-7 PTIs in addition to the Course Administrator (CA). For the sake of clarity, credit hour generation is assigned to the CA.

Table B-4c FY2004-2005 Credit Hours Taught by Nursing Faculty By Level and Faculty Type*

Faculty Type UG Core UG Lower Division UG Upper Division Graduate Tenured/Tenure Track (n = 16) 1216.5 705 1214 1959.25 Non-Tenured (n = 18) 835.5 1670 2558 1216.75 Total (n = 34) 2052 2375 3772 3176

* PTIs are generally clinical instructors who supervise 6-8 students in a clinical rotation. A clinical course can include 1-7 PTIs in addition to the Course Administrator (CA). For the sake of clarity, credit hour generation is assigned to the CA.

Table B4-d Average Number & Percentage of Weighted Credit Hours Per Year Taught by Faculty Rank (2002-2005)

Tenure/Tenure Track (Mean = 15) Non-Tenure Track (Mean = 15.6)

Average Credit Hours/ Year

Average Credit Hours/ Year

Percentage Taught

Average Credit Hours/TT Faculty

Average Credit Hours/ Year

Percentage Taught

Average Credit Hours/NTT Faculty

UG 7,928 (23,784/3)

2,638 (7,914./3)

33.3% 175.8 (2,638/15)

5,290 (15,870/3)

66.7% 339.1 (5,290/15.6)

MS PhD

2,817.6 (8,453/3)

1,928.2 (5,784.5/3)

68.4% 128.5 (1,928/15)

889.3 (2,668/3)

31.6% 57.0 (889.3/15.6)

UG Grad

10,745.6 (32,237/3)

4,566.2 (13,698.5/3)

42.5% 304.4 (4,566/15)

6,179.3 (18,538/3)

57.5% 396.1 (6,179/15.6)

Faculty workload can also be examined from the perspective of courses taught. Generally a T/TT faculty member in BFLSON teaches three courses one semester and two the other (5 per year). NTT faculty members teach approximately 3 courses per semester (6 per year), one of which may be a clinical practicum course. Our benchmark SONs indicated that T/TT faculty will teach from 3-7 courses per year, while NTT faculty teach 5-10 courses per year; see Appendix B6-a. The BFLSON faculty workload seems to be comparable to the comparison group, with the exception of USF that had a higher workload for both T/TT and NTT faculty. Many SON faculty “team-teach” the clinical courses. When reporting workload information each faculty on the team includes the team-taught course on their workload report. This may account for the heavier workload at USF.

Indicators of Program Relevance--UG Program: For the UG program, successful completion of the RN licensure examination (NCLEX) and employment are indicators of the program’s relevance for the students and the community. It is expected that by 2010 Georgia will have a nursing shortage of 23% (15,077 nurses). Applications to the BS program have increased enormously over the last three years, ranging between 400-500 applicants per year. By doubling enrollment in BS program in the last three years, we have increased the numbers of nurses employed in Georgia. Based on our students’ applications for Georgia State licensure, over 90% of our graduates are employed in Georgia following graduation.

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NCLEX success has increased over the last several years due to more stringent admission criteria, curriculum revisions, adjustment of the passing grade for UG nursing courses (74% is required to pass with a “C” versus the University standard of 70%), and most recently, a more competitive applicant pool; see Table B-5. Our NCLEX pass rates are closer to those of UTN and USC. USF has an average NCLEX pass rate of about 94%, however, they also report a very high attrition rate, graduating only 23 students per year. Attrition rates are also quite high for USC (88 graduates; 205 admissions) while UTN reports graduation and attrition rates (108 graduations; 112 admissions) more comparable with ours. See Appendix B6-a. Our goal is to increase our first time pass rates to 95%. As of 9/30/05, our first time pass rate for 2005 is 91.8%. Worth noting is the fact that approximately 95% of those students that are unsuccessful on the NCLEX examination on the first attempt pass the NCLEX examination on the second attempt. As these licensed nurses enter the workforce, we are contributing to the employment of professional registered nurses (RN) in Georgia.

Table B-5 NCLEX Pass Rates for Years 2000-2004* Year Percent 1st time takers Pass Fail 2000 73.7 38 28 10 2001 78.7 47 37 10 2002 80.4 51 41 10 2003 81.2 48 39 9 2004 82.2 79 65 14

Note: Pass rates are calculated based on examination success within the calendar year. Rates for 2005 are not available at this time.

Indicators of Program Relevance—MS Program. Indicators for the master’s program include success on the specialty certification examination and employment in an advanced practice role. Each year our masters’ program graduates over 50 advanced practice nurses who work in both primary care settings and acute care agencies. These nurses contribute to the public welfare by providing patient care in outpatient and acute care settings. Although all certifying bodies do not notify us of pass rates for certification examinations, student reports suggest that the success rate on certification examinations is in the 90% range for our graduates. Student reports also indicate that the large majority of our MS-prepared nurses find employment in their specialty area, thus demonstrating that the numbers and diversity of our programs are appropriate and meet a need for APNs in multiple areas; see Appendix D1-b Learning Outcomes for Master’s Program. Finally, a large majority of our advance practice graduates work in Georgia; many of these work with underserved populations, also meeting a public need.

Indicators of Program Relevance—PhD Program. Indicators for the doctoral program include scholarly productivity and, to some degree, employment as a faculty member in nursing an academic setting. The shortage of nursing faculty and nurse researchers parallels the shortage of nurses providing “hands on” patient care. Our doctoral program prepares nurses who contribute to nursing and health care science. A complete account of our PhD graduates’ employment and accomplishments is not available. Of the 28 PhD graduates from 2000 to 2005, we were able to determine that 18 out of 20 (90%) are employed in academic institutions, 12 (60%) of these graduates are employed in Georgia institutions. Thus our PhD graduates contribute to ongoing quality nursing education for students. Data collection on PhD graduate productivity is underway as a part of our learning outcomes assessment. A formalized approach to collecting student data on publications, participation in nursing organizations, etc. is being developed; however, available data is reported in the Learning Outcomes for the Doctoral Program (Appendix D1-c).

The selection criteria for our benchmarking institutions are reported in Appendix B1. Only three [University of Tennessee at Knoxville (UTN), University of South Carolina (USC), University of South Florida (USF)]of the six SONs responded to our request for data. There are many similarities and differences between the BFLSON and responding institutions; see Appendix B6-a for a summary of the data and B6-b for the individual SON data. In size, the UTN is most comparable in the number of UG students. USF’s MS enrollment is most

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comparable to ours, while our PhD enrollment surpasses USC and UTN but is about 10 students lower than USF. Our nursing UG program has more cultural diversity with approximately 50% of our UG students from diverse cultural backgrounds. Diversity in our MS programs is also greater (53%) than that reported by our comparison groups (USC: 21%; USF: 16%; UTN: 2.5%). Twenty-eight percent of our doctoral students are from culturally diverse backgrounds. As noted, our faculty numbers are less than our comparison institutions, even when compared to UTN that enrolls a comparable number of students but reports a faculty complement of 44; in the BFLSON, we have 34 full-time faculty.

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C. Progress Toward Goals and Objectives Since Last Academic Program Review

The first review cycle for the SON was a two-pronged process. The BS and MS programs were reviewed in 1996-1997 (see Executive Summary in Appendix C-1); the PhD program self-study was prepared in 1993 (see Appendix C-2). A strategic plan was not presented in the BS and MS program self-study, however, the SON indicated in a follow-up report that a strategic plan would be developed. In the BS and MS self study (pp. 4-5), the SON noted three foci (goals) for the next decade: a) increasing interdisciplinary scholarship, b) continuing to engage in community-focused programs, and, c) increasing research productivity. The goals and objectives presented in the PhD self-study were essentially the program goals and objectives (see Appendix C-2, p. 2); data in the report indicated that all these goals were met based on available student reports and student success in program completion.

In the following section we have responded to the recommendations of the APACE/APRC committees’ reviews of our programs (1993; 1997) as these recommendations included the foci for the BS and MS programs and goals for the PhD program as noted above; see Appendix C-3 for Graduate Council Response to Doctor of Philosophy in Nursing Program Review and Appendix C-4 for the APRC review of the BS and MS programs.

Summary of Doctoral Program Progress: In Appendix C-5, a more detailed account of the SON’s progress related to the recommendations of the Graduate Council can be found; a summary of this account is presented here. In general, we currently average about 27 students in the doctoral program, approximately half the number enrolled at the time of the self-study. The summer PhD program was deactivated based on recommendations of the APR PhD program evaluation. Our faculty members meet the criteria for graduate faculty status as established by the CHHS (Appendix F1). Currently 13 faculty members in the BFLSON hold graduate status; see Appendix F2). Only faculty members with graduate status and good track records in research and scholarship chair dissertation committees. The most recent faculty review of the doctoral curriculum was held in Spring 2005 with some course revisions and additions planned for Fall 2005. Some advancement in Federal research grant submissions has occurred, however, this continues to be a goal. Mentoring of new T/TT faculty is resulting in increased research and manuscript productivity. No recruitment plan of doctoral students at the national level has been developed.

Because of the high demand for doctorally prepared nursing faculty in Georgia, we are seeking approval and funding from the Board of Regents to implement a web-facilitated PhD program. It is anticipated that the web-facilitated program will attract students on a regional and national basis.

Summary of BS and MS Progress: In Appendix C6, a more detailed account of the SON’s progress related to the recommendations of the APRC can be found; a summary of this account is presented here. The SON developed an action plan as noted in the Action Report, 1998 (Appendix C7). Since that time the strategic plan was updated (2002-2003). During a faculty retreat in Spring 2004, the ground work was set for the development of a new strategic plan. In August 2005 University consultants guided faculty through a strategic plan development process. The 2005-2008 Strategic Plan was approved by the faculty on September 26, 2005; see Appendix H2.

Admission standards and goals related to part-time versus full-time student enrollment have been addressed. The UG student admission criteria have been strengthened by the addition of the ERI Nursing Entrance Test. UG students are admitted on a full-time basis. The number of students admitted to the UG program has been capped at 112 per year due to faculty and clinical site availability and financial resources.

The majority of MS students begins their program of study on a part-time basis but generally move to full-time status once their clinical courses are underway. To assure continuity of education, MS students are required to have continuous enrollment throughout their education program. Since the 1997 report two low enrollment tracks were eliminated: the Child Psychiatric Mental Health Nursing track and the Gerontology Nursing track. The Adult Psychiatric Mental Health Nursing program was revamped to include psychiatric care

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of both the adult and the child. Enrollment in the PMH CNS track remains low; however, the BLFSON is the only state school that prepares nurses for advanced nursing practice in psychiatric mental health nursing. To manage this low enrollment, the courses are offered every other year rather than every year as in other tracks. The AHN CNS track had some increase in enrollment in the last year. A faculty task force prepared a proposal for a change in this track to offer the Adult Health Clinical Nurse Specialist/Nurse Practitioner track. This proposal was approved by the faculty in Fall 2005. We will admit the first students in Fall 2006. We currently have a temporary enrollment cap on the FNP program (32 students per year) due to limited availability of faculty and expert clinical preceptors and financial resources.

The department organizational structure reported in the 1997 self study has been replaced by a committee structure. Over the past three years the number of full-time faculty has averaged 30.6, approximately 3 positions less than reported in the 1997 report. At the same time, student enrollment in the BFLSON has increased significantly beyond that noted in the 1997 report as can be seen in Table B-3. Faculty productivity (51 articles, 151 meeting presentations, 49 other publications, some small grants) has increased since 1997 as noted Table B-2. Whenever possible, faculty workload is decreased for T/TT faculty who are active in research development and/or implementing studies funded by small grants. In addition, the Director works with individual faculty members to adjust their workloads to meet research and scholarly productivity goals. Finally, a research consultant has been employed for the last two years to mentor faculty in research and publication development. Tenure track faculty members receive priority for travel funds to present research and attend research development programs. One staff member is assigned to assist faculty with technical aspects of grant proposals and for management of grant budgets.

Since 1997, some community projects have been eliminated due to increased student enrollment and a decrease in the number of full-time faculty in the BFLSON. The BFLSON continues to support the Health and Wellness Nursing Collaborative and the Martin Luther King Middle School initiative.

As noted in previous reports, major flooding was reported in the Nursing Instructional Lab in R188 Kell Hall. Renovation of the Instructional Lab was done in 2002, since that time there have been only minor problems with leaks. A new Science Teaching Laboratory building is projected for completion in 2008. This will provide some relief in our need for quality laboratory teaching space.

D. Curricula Quality

Evidence of Student Learning: In 2003-2004, the learning outcomes assessment plans (LOAP) for each nursing program were developed based on objectives for each program. In 2004-2005 the learning outcomes assessments were completed. The learning outcomes will be discussed for each program below. After using these LOAP for the first time, it is clear that some refinement is needed prior to future use.

Learning Outcomes—Undergraduate Program: Over the last 3-4 years, major refinement of the UG curriculum and implementation of more stringent admissions criteria and grading have resulted in better student outcomes. The LOAP for the UG program has documented most of those successes; see Appendix D1-a. As can be seen in the assessment summary all learning outcomes have been attained by students in the BS program, including better NCLEX results and a higher first time pass rate on the ERI exit examination. In spite of these accomplishments, the faculty seeks to increase the percentage of students who pass NCLEX the first time to 95%. No major curriculum changes are planned given the improved outcomes, however, monitoring of outcomes will continue and strategies for improvement implemented as identified.

Learning Outcomes—Master’s Program: The LOAP for the MS program can be found in Appendix D1-b. As can be seen in the assessment summary, some of the learning outcomes have been achieved while others have not. In some cases, the learning outcomes items were more difficult to measure than expected. In other cases, a precise measurement of the learning outcome is not attainable from the survey items. In addition,

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alumni response rate to 1-, 3-, and 5-year surveys was relatively small limiting the interpretation of the data. It is clear that the LOAP for the master’s program needs refinement. Also better ways of obtaining post-graduate data will be explored. Two key outcomes seem to be supported—successful employment at the advanced practice level and certification in the specialty. In Summer 2005, we made some revisions in our new graduate, and 1-, 3-, and 5-year alumni surveys to obtain more specific data. However, further refinement is needed, thus a graduate faculty task force will be appointed during 2005-2006 to make recommendations for modifying our evaluation forms.

Learning Outcomes—PhD Program: The LOAP for the PhD program can be found in Appendix D1-c. As can be seen in the assessment summary, some learning outcomes were achieved while others were not. Clarity was lacking in some indicators. A regular process for collecting student data was not in place. A change in administration resulted in a gap for student and alumni data collection in Summer 2004. Faculty and administration will work to refine measurement of outcomes and develop a regular protocol to collect student data. In addition, refinement of the PhD alumni survey will be done. Finally, the refinement of the doctoral curriculum is underway. Several courses are to be restructured and two statistics courses are being added. Due to potential and current student requests and a need for a quality doctoral program that is accessible to non-PhD prepared nursing faculty in Georgia, a web-facilitated doctoral program is being explored.

Writing Intensive Courses: Although writing is clearly a skill that professionals should have, the BFLSON does not have writing intensive courses as designated by the University. However, we have identified one course in the UG curriculum (N4600 Leadership & Management in Nursing) and one course at the master’s level (N7900 Theoretical Foundations in Advanced Practice Nursing) where writing skills will be developed. One faculty member who teaches N4600 has had writing across the curriculum training at the University of Michigan and offers writing enhancement activities in the course. In N4600 50% of the student’s grade is based on written papers. In Fall 2005, this faculty member plans to submit N4600 for writing intensive status in the University. For N7900, we are increasing the number of faculty assigned to the course to create a situation where writing skills can be enhanced via direction from skilled faculty.

Evaluation by Faculty, Students, and Recent Alumni: Faculty Evaluation: Twenty-three of the thirty full-time faculty completed the faculty evaluation surveys; response rate = 76.6%. The 15-item faculty satisfaction survey data can be found in Appendix D5-a and D5-a1. Of these, ten mean scores were equal to or exceeded the University mean while five fell below the University mean. Faculty teamwork in working toward program goals was rated very high, indicating that the overall morale among faculty is good. Satisfaction with scholarship of the faculty, availability of relevant computer software, and guidelines regarding job performance fell slightly below the University mean. The emphasis on research (Mean = 3.13) and service to the department (Mean = 3.17) was slightly below University means yet fell in the 3.0 range which would suggest that the emphasis on these two areas was adequate. Eight faculty members provided written comments about the BFLSON. Positive comments focused on advances in quality of student education and faculty development, administration and leadership, availability of mentoring, and good morale and teamwork among faculty. The need for more guidance for new faculty, the need for seasoned researchers, increased accountability for research and scholarly productivity, lack of adequate support/mentoring for research and publication, dissatisfaction with administration and leadership, and inadequate communication to faculty and students were areas identified for improvement. A mentorship program for new faculty was established two years ago. Recently two full-time and one part-time nursing faculty persons with advanced research skills have been hired. Strategies for research and scholarship support have been implemented and are described in Appendix C6, #6. In general the faculty was positive about the unit’s morale, teamwork, rigorousness of the curriculum, and their ability to influence decisions within the unit. Although faculty retreats have been held over the last few years for unit goal-development, it is clear that more continuity is needed in discussion and evaluation of these goals.

Undergraduate Student Evaluation: Eighty-one (50%) of the 162 UG students who received the 14-item University survey responded. Appendix D5-b contains the OIR report; Appendix D5-b1 presents the summary of the data. The mean scores of seven of the items were equal to or slightly above the University mean. Students agreed that the UG program of study was challenging, the availability of faculty was good, and degree

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requirements were clear. The mean scores of seven items fell below the mean scores from University students. Of particular concern are students’ mean scores on teaching skills, styles, and preparedness of faculty. Although these scores all fell within the 3.0 range, all areas need improvement. Supplemental questions were added to the UG survey. Students rated the overall quality of their clinical courses (Mean = 5.19) and classroom teaching (Mean = 4.71; range: 1–7) as relatively high. Qualitative data highlighted the need for improvement in faculty teaching skills, administrative communication and organization, timely communication from some faculty, and advisement, particularly from new teachers. Students indicated that faculty members were available to students and willing to work with them.

Graduate Student Evaluation: The graduate student survey data can be found in Appendix D-5c and D5-c2 (qualitative data); a summary of these data can be found in Appendix D5-c1. Seventy students (33.2% response rate) rated the BFLSON comparable or above the comparison rates of University students. Students were in agreement that the graduate program is academically challenging, is preparing them for their professional career, open communication exists between faculty and students, career and academic advisement are available, and degree requirements are clear. The two issues that need to be addressed include a lack of faculty preparedness for their courses and large class sizes and their effect on learning. Several good suggestions were presented and will be discussed with faculty in Fall 2005.

Undergraduate Alumni Evaluation: The results of the UG alumni survey and comments can be found in Appendix D5-d; a summary of these data can be found in Appendix D5-d1. The mean scores for all items completed by 41 UG nursing alumni fell below the mean comparison scores of University students, with the means of three items falling below 3.0 (lack of open communication between faculty and UG students, the availability of career advisement, and frequency of UG major course offerings). Career advisement is integrated in program advisement and may not be recognized as such by students. Another possible explanation may be related to the nursing shortage. Faculty may not emphasize this aspect of advisement. We will bring faculty attention to this issue so that both program and career advisement are provided. All required UG nursing courses are offered annually with the clinical courses being offered 2-3 times per year. Faculty teaching effectiveness and open communication between faculty and students are of major concern. The fact that these alumnae may have been exposed to changes in the curricula and stricter regulations regarding admission and progression may have affected their responses. Regardless, the faculty needs to be aware of alumni responses and seek to improve these responses. This may be best approached by developing an action plan based on the results of survey that went to current UG nursing students. Understanding current student issues and identifying strategies that address their issues raised should enhance future alumni satisfaction.

Graduate Alumni Evaluation: In Fall 2004, 66 alumni responded to the graduate alumni survey producing a response rate of 41.8%. Data from the graduate alumni survey can be found in Appendix D5-e; a summary of these data are presented in Appendix D5-e1. To a large extent the results of the graduate alumni reflect the responses of current graduate students. Students agree that the graduate program was academically challenging, the nursing program prepared them for their professional career, open communication existed between faculty and students, and academic and career advisement were available in the BFLSON. Issues of concern focused on the following areas: the effectiveness of faculty teaching methods, procedures to evaluate student performance, the frequency of graduate courses, the suitability of class size for effective learning, and clarity of degree requirements. Self-identified PhD alumni mentioned the need for further information on grant writing, funding opportunities, and publication. Like their student counterparts, some MS students were displeased with having to locate their own clinical sites. In response to this student concern, all clinical course coordinators are securing clinical sites for students. Although each student is assigned an adviser in their specialty area, a few students indicated that advisement was less than satisfactory while most indicated it was excellent. In Fall 2005 faculty will review these results along with the results of current graduate students and identify and implement strategies for improvement.

Degree Requirements: Degree requirements for UG students can be found in Appendix D3-a. During the past seven years there have been significant changes in the UG curriculum as courses have been created (e.g. NUR 2080), modified (merging of clinical courses—e.g. NUR3510 (classroom; 3 credits) with NUR3520

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(clinical, 2 credits), and others deleted. These course enhancements have made significant improvement in student outcomes (grades and first time pass rates on ERI exit and NCLEX examinations). The basic curricula for the MS (Appendix D3-b) and PhD (Appendix D3-c) programs have remained the same with some modifications as described previously. Refinement of the MS and PhD curricula will be implemented in Fall 2005 based on the results of faculty workshops held in Spring 2005.

Appendix D4 (formerly Table D-1) contains a list of course offerings by year, term, level, number of sections and students, and average number of students. For the UG courses, the average number of students per section is high. In cross-listed courses (BS and RN-MS), the average number of students per section is adequate in required courses and low in electives and two RN-BS/RN-MS courses. In the MS courses, core courses accommodate a large number of students while course enrollment in some of the specialty areas is low. As previously noted, strategies have been put into place to boost student numbers in low enrollment courses and to offer more sections for courses with extremely high enrollment and courses with a writing component. In general student enrollment at the doctoral level is acceptable with 7-10 students admitted annually. In a few instances admission numbers fell below the preferred numbers.

Student advisement procedures are described in Appendix D6. Students in all programs have faculty advisers who authorize course registration, assist in curriculum planning, and offer assistance with problems/issues shared by students. In student evaluations, we found that the majority of the faculty receives positive evaluations related to faculty advisement while only 2-3 faculty members receive unfavorable comments. Faculty advisement training has been provided to faculty, both experienced and new. We are working to improve our performance in this area.

E. Student Quality

Undergraduate Admissions Criteria: Criteria vary for admission to the traditional and accelerated tracks in the UG program. Students entering the traditional track and the RN-BS track must have a 2.5 GPA, while students in the accelerated track are required to have a 3.0 if they have no other degree and a 2.8 if they have a degree in another discipline (Appendix E1). It is important to note that students who are admitted exceed the minimum admission criteria. Applicants are also required to take the Educational Resources Inc. Nursing Entrance Test (NET), which assesses reading and math ability. All applicants must have reading and math scores at high school level or above to be considered for admission. We have not regularly had access to SATs scores as many students transfer into the University and these scores have not been readily available. UTN reports a similar situation; as an upper division program they do not use ACT scores for admission; see Appendix B6-a. Our traditional students are admitted into the nursing programs in their sophomore year so we focus our attention on their performance in their science courses and GPA. With the inclusion of the NET, we can be more selective in admissions as we have a better understanding of applicants’ reading and math levels. None of our comparison SONs requires a standardized admission test like the NET even in situations where they do not use SAT/ACT information for admissions. However, we prefer a standardized measure of performance for admission as SAT scores are not always available. We are very pleased that our applicant pool has greatly increased with public exposure of the reality of the nursing shortage, thus enhancing student selection. Unfortunately we have to turn away qualified applicants (over 200 per year) due to the shortage of full-time faculty and PTIs.

Masters Admissions Criteria: Admissions requirements for the program can be found in Appendix E2. Required GPA for admission into the MS program is 2.75; mean GPA for each of the past three years exceeds the requirement (Table E-1a). Only one benchmarking SON reported GPAs for MS students; see Appendix B6-a. The mean GPA reported was 3.7 (range: 2.9-4.0), which is considerably higher than our mean GPA for admitted students. [Note: although the OIR data provided some GRE scores for our MS applicants, the GRE is not currently required for admissions. It was only required for students who did not meet admission criteria. Effective in Spring 2006, all MS applicants will be required to take the GRE.]

Table E-1a Mean Standardized Master’s Admission Test Scores and GPAs for 2003-

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2005 Year Master’s Applicants Admitted Students Matriculated Students

GPA Ad. Test GPA Ad. Test GPA Ad. Test Score* Score* Score*

2003 3.09 3.27 3.26 2004 3.04 3.18 3.23 2005 2.98 3.07 3.06

• No admission tests were required.

PhD Admissions Criteria: Criteria for admission to the PhD program can be found in Appendix E3. GPA and GRE scores are carefully examined for applicants in the PhD program. Only one of our benchmarking institutions gave us GPA and GRE data; see Appendix B6-a. USC reported a mean GPA score of 3.7 for their PhD students. As can be seen in Table E-1b, the mean GPA scores for students admitted to our PhD program are almost identical. As results demonstrate in Table E-1b, students’ GRE scores are not optimal as we would like to see our average for verbal and quantitative sections exceed 1000. Over the last three years, the mean total score for the verbal and quantitative sections was 965; verbal score means = 493; quantitative score means = 471. USC reported a mean total GRE score of 1015 (range: 830-1140) for their PhD candidates. Their mean score for the verbal GRE was 505 (range: 370-630) while the mean score for quantitative was 510 (range: 400-620). We have also gathered some data from Graduate Record Examinations website; see Appendix E4. The GRE website reports that the general test percentage distribution of scores within nursing based on seniors and non-enrolled college graduates are as follows: Verbal—Mean = 454, S.D. = 84; Quantitative—Mean = 519, S.D. = 110; Analytical— Mean = 4.2, S.D. = 0.8. Our average student admission verbal score exceeds that reported by GRE, while our quantitative mean score falls considerably below that reported by GRE. While GRE performance is an important admission criterion and one we want to strengthen among our admitted students, other criteria are important in our program focused in preparing health care researchers.

Our PhD applicants apply for doctoral education approximately 15-20 years post-baccalaureate degree. The time lapse of many years between completion of the BS and MS degrees with exposure to formal mathematics courses and application to the PhD program probably contributes to lower performance on any standardized test including the GRE. Historically we have found that other factors are important in considering candidate admission to the doctoral program. One factor that is heavily weighted is the student interview wherein student ideas for research, the match of their research interests with faculty expertise, and their commitment to doctoral education can be explored. Also their professional accomplishments and graduate GPA are scrutinized. We are strongly encouraging our applicants to prepare for the GRE prior to taking it. For Fall 2005, three applicants were requested to repeat the exam with some improvement in their scores.

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Table E-1b Mean Standardized PhD Admission Test Scores and GPAs for 2003-2005 * Admission test is GRE; score reported on quantitative and verbal.

Year PhD Applicants Admitted Students Matriculated Students GPA GRE GPA GRE GPA GRE

2003 3.78 T 890 3.78 T 936 3.91 T 906 V 427 V 447 V 447 Q 463 Q 489 Q 459

2004 3.64 T 983 3.63 T 1003 3.63 T 1003 V 489 V 513 V 513 Q 494 Q 490 Q 490

2005 3.83 T 955 3.88 T 903 3.91 T 985 V 520 V 510 V 520 Q 435 Q 393 Q 465

Acceptance rates for the MS and PhD programs are presented in Tables E-2a and E-2b. Acceptance rates for the MS program were lower in 2005 due to a cap on the FNP program. A larger number of FNP students were admitted in 2004 than we could readily accommodate in classes and clinical sites. Consequently, admissions in 2005 were deliberately reduced. Applications for these programs are strong as is the applicant pool. The admission rate for the PhD program was down in 2004. Many of the applicants did not complete the application process or failed to meet admission requirements.

Table E-2a Selection Ratio of Applicants/Accepted Master’s Students for 2003-2005 Year # of Applicants # Accepted Ratio 2003 187 98 1.9:1 2004 290 150 1.9:1 2005 269 114 2.4:1

Table E-2b Selection Ratio of Applicant/Accepted PhD Students for 2003-2005 Year # of Applicants # Accepted Ratio 2003 12 7 1.7:1 2004 12 4 4:1 2005 17 9 1.9:1

Student Performance: Student outcome performance has been greatly enhanced in the UG program over the last few years due to more stringent admissions criteria, revision of the UG curriculum and a more competitive applicant pool performance. The NCLEX first time pass rate has steadily increased; see Table B-5. Student performance on the ERI Exit Examination (end of program examination on the application of clinical content) has improved. In Spring 2004 all students passed the Exit Exam on the first attempt but only 81.2% of the graduates passed NCLEX the first time. The passing score for the ERI Exit Examination is being raised so that student performance on the exit examination is a better predictor of NCLEX success. For more information on outcomes, see Appendix D1-a, UG Learning Outcomes Assessment Plan.

Student completion of the MS program has been high in all specialty tracks. Certification rates are difficult to track; however, first attempt rates are estimated to be approximately 90%. For more information on MS outcomes, see Appendix D1-b, Assessment of Master’s Program Learning Outcomes.

Student performance in the PhD program has also been high. Although we have not effectively tracked the productivity and employment positions of our graduates, we are aware that many hold academic leadership positions, have attained grants, and have published. See Appendix D1-c Assessment of Doctoral Program Learning Outcomes for more information on student performance.

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F. Faculty Quality

During Y2004-05, fulltime faculty members numbered 34; see Appendix F3 for faculty curriculum vitae. Of these 16 held tenure/tenure track (T/TT) positions. This is an increase of T/TT slots from the averages reported in Table B-1 (Average T/TT: 11.6 positions). The BFLSON strives to hire doctoral-prepared faculty to further enhance research and scholarship productivity. The nursing faculty shortage continues to influence our success in hiring such individuals; however we are pleased with our progress to date.

In Y2004-2005 our full-time NTT numbered 17, one less that the average reported for the 3-year assessment period. Our NTT faculty members have strong clinical nursing backgrounds that enhance their teaching skills, strengthen the students’ education, and meet faculty requirements for specialty certification when teaching at the master’s level. One of the requirements of certifying bodies (e.g. American Nurses Credentialing Corporation [ANCC]) is that students in master’s advanced practice nursing specialty tracks must be taught by nurses who are certified in those tracks. In 2004-05, eight T/TT and eleven NTT faculty were certified in their specialty areas. We are pleased to have such qualified faculty. However, one recruitment issue that arises is the fact that the number of certified advanced practice nurses who are doctoral-prepared is very limited. This issue presents a struggle for us as we try to increase the number of our T/TT faculty and to simultaneously balance our needs for certified advance practice nurses.

As noted in Table B-2, faculty productivity has been increasing over the last three years. The average number of publications (n=17) by the average number of full-time faculty (n=30.6) was 0.55 publications per faculty per year. Until this year, NTT faculty members were not expected to publish to attain promotion; however 2 refereed articles were published by faculty of this rank. The average number of refereed publications (n=49/3=16.3) by the average number of T/TT faculty (n=15) is 1.08 publications per year. Publication of refereed articles, conference presentations, and other publications have increased in the last three years, averaging 17 referred publications, 50 presentations, and 16 other publications per year. In the last year the number of books, chapters, etc. has doubled. Although our productivity numbers are not as high as those reported by our benchmarking institutions, we are pleased with our accomplishments when compared to USC (26, 27, and 40) and USF (no reports on referred articles, 12, and 8) that have about 30 more full-time faculty than we do and UTN (21, 3, and 40) that reports 10 more faculty; see Appendix B6-a. A concerted effort is being made to increase faculty productivity. The Research Interest Group fosters collaboration on articles and offers review of manuscripts and suggestions for journal selection.

The annual mean for external and internal funding is $4,298,327 and $209,164, respectively. Grant sources are varied with most of the faculty receiving small grants for research endeavors. Although we did not ask for actual dollar data from our comparison institutions (see Appendix B6-a), we could see by the numbers of funded grants, particularly those that are federally or foundation-funded that we have room for improvement. As the number of faculty researchers grows, we expect to see an increase in funding at all levels.

During the academic years of 2003-2005, two faculty members applied for tenure and one for promotion; both were awarded tenure and one was promoted to professor. In 2002-2003, one faculty member was promoted to Associate Professor. In 2004-05 four NTT faculty applied for promotion; two were awarded promotion. Two faculty members were denied promotion due to a lack of publications. The BFLSON is now considering strategies to promote increased scholarly publications among NTT faculty.

Faculty members have also been involved in professional and public service; see Appendix F5. They have served on editorial boards for such journals as Issues in Mental Health Nursing; Journal of Nursing Measurement; Med-Surg Nursing, the Journal for Adult Health Nurses; and more. Fifteen faculty members serve as manuscript reviewers for professional journals (e.g. Journal for the Association of Nurses in AIDS Care; Journal of Nursing Scholarship; Women’s Health Issues: Official Publication of the Jacobs Institute of Women’s Health); the Journal of Nursing Measurement. One faculty member recently served as the President of the Georgia Nurses Association while another is currently President of the Academy of Medical-Surgical Nurses. Three of our faculty members are Fellows in the American Academy of Nursing (FAAN) and two additional

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faculty members were recently selected as FAAN. Other professional service includes such activities as member of the Board of Directors for the Society for Menstrual Cycle Research (an international research society); grant reviewer for DHHS, HRSA; item writer for the 2004 Menopause Practitioner credentialing examination; member of the Medical-Surgical Nursing Certification Board; reviewer for the American Rehabilitation Nurses Association Core Curriculum; and more. Community service is important to our faculty and the capacity of that service varies (e.g. Member of the Governor’s Taskforce on the Uninsured; member of the Governing Council of the American Public Health Association; appointment to the former Governor’s Office on Women’s Health; consultant to Georgia (Russia) on developing nursing education; member of the Georgia Hospital Association’s Professional Advisory Committee; member of the Board of Directors for Pregnancy Resource Center of Atlanta; member of the Board of Trustees of the Unitarian Universalist Congregation of Atlanta; Service Unit Director of Decatur, Girl Scouts of Northwest Georgia; and more). Faculty members serve on 18 professional boards at the city, county, state, and national level. In addition, some faculty members volunteer their clinical expertise at such facilities as Planned Parenthood of Georgia. See Appendix F5 for more on faculty service.

The process for the development of the self-study and faculty involvement in its preparation is reported in Appendix F4. Faculty members have been informed and updated throughout the preparation of this self-study as is reflected in faculty minutes. Faculty participated in the faculty survey. The Self-Study Task Force consisted of four faculty members, the Director, and a staff member. Members of the Undergraduate Program Committee and the Graduate Program Committee reviewed early drafts. A faculty workshop was held in October 17, 2005, to refine the document.

G. Resource Adequacy

Faculty Resources: Faculty resources have been strengthened recently with the appointment of faculty with research and clinical expertise. We are pleased with the increase in faculty numbers, however, the workload of current faculty is at a maximum given release time and student enrollment. One issue that impacts faculty resources is the need for a variety of content expertise for clinical courses. It is essential to have sufficient faculty in the various specialty areas (adult health, child health, mother/child health, mental health, and community health) to assure quality teaching in these specialty tracks. In addition, some of the core courses require faculty with specific expertise (e.g. advanced pathophysiology and pharmacology). These courses tend to have large numbers of students enrolled. As a result faculty are less likely to want to teach these courses on a continuing basis. We are continually challenged to have the “right” faculty specialty complement.

T/TT faculty account for 33% of credit hour generation with UG students and 68.4% of the credit hours generated by graduate courses. NTT faculty members teach 66.7% of the UG credit hours and 31.6% of the graduate credit hours. As previously noted, NTT faculty members with certification in specific specialty areas must teach students in these clinical tracks as required by credentialing agencies. Thus, some NTT faculty members teach students in the master’s programs.

Table G-1. Student/Faculty Ratios FY 2003-2005 FY 02-03* FY 03-04** FY 04-05

# TT Faculty/#TT teaching UG 1.8: 1 (13/7) 1.4:1 (14/10) 1.5:1 (15**/10) # NTT Faculty/# NTT teaching UG 1.2:1 (15/13) 1.1 (14/14) 1:1 (18/18) # Total Faculty/# teaching UG 1.4:1 (28/20) 1.7:1 (28/24 ) 1.2:1 (33/28) # Undergraduate Majors 240 287 294 UG/TT Ratio 32.3:1 (240/7) 28.7:1 (287/10) 29.4 (294/10) UG/NTT Ratio 18.5:1 (240/13) 20.5:1 (287/14) 16.3 (294/18) UG/Total Faculty Teaching UG Ratio 12:1 (240/20) 11.9:1 (287/24) 10.5:1 (294/28) # Graduate Majors 176 208 246 Grad/TT teaching Grad Ratio 16:1 (176/11) 18.9:1 (208/11) 27.3:1 (246/9) Grad/NTT teaching Grad Ratio 19.5:1 (176/9) 69.3:1 (208/3) 35.1:1 (246/7)

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FY 02-03* FY 03-04** FY 04-05 Grad/Total Faculty teaching Grad Ratio 8.8:1 (176/20) 14.8:1 (208/14) 15.4:1 (246/16)

# Graduate Faculty 14 14 13 # Ph.D. Students 27 28 28 Ph.D.Students/Graduate Faculty Ratio 1.9:1 (27/14) 2:1 (28/14) 2.1:1 (28/13)

*Drs. Kelley and Baldwin are not counted in credit hour generation due to release time ** Dr. Kelley is not counted in credit hour generation due to release time

Our benchmarking SONs provided us with data on student to faculty ratios; see Appendix B6-a. As can be seen in Table G-1, our student to faculty ratio at the UG level averages 11.5:1. This ratio is much better than those reported by our comparison SONs (UNC = 25:1; USF= 40:1; UTN = 30-60:1). Our UG student to clinical instructor ratio is 6-8:1; our comparison SONs report similar or higher ratios (UNC = 8:1; USF = 12:1; UTN = 8:1). At the MS level, our student to faculty ratio is 13:1, again surpassing our benchmarking colleagues (UNC = 15:1; USF = 25:1; UTN = 20-25:1). For graduate clinical experiences, our student to faculty ratio is 10:1, while our benchmarking SONs report a range of ratios (UNC = 5:1; USF = 12:1; UTN = 6:1). One of the specialty certification organizations recommends a MS student to faculty ratio of 8:1. The availability of adequate numbers of certified advanced practice nurses limits decreasing our MS student to faculty ratios in some cases.

As noted in Section B of this report, the need for PTIs to provide clinical teaching in health care agencies causes a financial strain on the budget. These PTIs do not directly generate credit hours as they are part of the team that supervises student clinical experiences within a course that includes classroom and clinical practice experiences. For example, during Fall 2004, Spring 2005, and Summer 2005, 52 PTIs covered 65 clinical rotations at the cost of $274,700. Table G-2 shows the budget allocations for PTIs for the last four years. Each year the budget allocations fell short of the expenditures for PTIs. These deficits increased considerably when enrollment numbers doubled with the initiation of the UG accelerated track. The budget deficits for the cost of the PTIs have been supplemented with indirect cost funds, release time monies, Tenet and ICAPP grants and support from CHHS when necessary. The indirect cost funds and release time monies that are used to supplement the cost of PTIs could be best directed to support faculty research development and scholarly productivity. As ICAPP support ends in Spring 2006, we will not have adequate resources to cover this deficit. It is impractical to replace these PTIs with full-time faculty as the need for various clinical specialty expertises, clinical agency rotation schedules, and the actual time requirements for the clinical rotations limit the number of clinical rotations that a full-time faculty member could do. The use of PTIs with clinical expertise is the most efficient approach to providing regulated clinical expertise. The issue is adequate funding for these PTIs.

Table G-2. Budget Allocations and Expenditures for Part-time Clinical Instructors 2001-2005

Year Allocations Expenditures Annual Budgeted Deficit 2001-2002 $133,930 $139,600 ($5,670) 2002-2003 $125,263 $152,640 ($27,377) 2003-2004 $125,263 $212,200 ($86,937) 2004-2005 $125,263 $205,200* ($79,937)

• Does not include Summer 2005 expenditures which will appear in the 2005-2006 budget.

Due to faculty workload, we are unable to keep the Nursing Learning Laboratory open several days a week for student practice. Our lab coordinator does offer open hours for practice as much as possible, however, her availability is limited by her teaching responsibilities. Ideally we would like to have a part-time nurse work in the lab 2-3 days per week to assist students with health assessment and nursing skills practice and support faculty in the use of Meti-Man, computerized patient and baby models, for demonstration and practice. Again, the salary for a part-time nurse laboratory assistant is not currently covered in our budget.

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Another human resource that we must arrange for are human models for advanced physical assessment courses for MS students. Although these models are only needed two semesters of the year, they are a regular annual expense capping at up to $7,200 per year. Models are paid $25-$50 per student examination; each student performs a male and female examination. Up to 72 students take the health assessment course annually, resulting in costs up to $7,200 per year. This cost is not covered in student fees and tuition; it is covered by BFLSON. A special/unique fee for the health assessment courses would alleviate this expense to the unit.

Administrative Resources: One business manager and eight staff members support the faculty. The business manager does not generally support faculty work needs, thus is not counted in the faculty to staff ratio. One staff member who worked half-time became full-time during 2004-2005 while seven have been full-time for the last three years. The 3-year average of staff members is 7.7 persons (23/3). The average faculty to staff ratio for the last 3 years is 3.9:1 (30.6/7.7). The transition of the part-time staff member to full-time has relieved some of the UG staff workload as she assists with admission files (~450 per year) and required clinical site placement materials. Student assistants have been very helpful by assisting with some of the staff workload.

Technological Resources: Technological resources within the BFLSON are generally satisfactory. Although some unit computers are aging, attempts are being made to replace them. ITS staff is very responsive to requests for technological assistance.

Through technology fee funding we have been able to purchase computerized adult and child simulation models and some additional equipment for the Nursing Learning Laboratory in 188 Kell Hall. However we do not have the funds to assign a faculty member to incorporate use of these models into the curricula. To use this equipment to its fullest and increase learning opportunities, we need a part-time nurse to open the Nursing Learning Laboratory for student and faculty use; see discussion above.

One major technological deficit is the lack of available computers for student testing. We prefer to give our students examinations electronically. This is particularly important for UG students who will take NCLEX examinations electronically upon graduation. Our clinical courses average approximately 60 students in the class; some courses have over 80 students. We prefer to give the examination to all students in the course at the same time in a controlled environment to maintain security. Computer rooms of this size are difficult to find which creates a critical challenge for us.

Space Resources: With the addition of new faculty and renovations on other CHHS units, the BFLSON is bulging with faculty, staff, and faculty from other departments. It is our understanding that, once the renovations are completed on the 9th floor and displaced faculty move to permanent locations, we will be given access to additional offices on the 9th floor, including space for research activities and data storage.

Laboratory Resources: The Nursing Learning Laboratory was renovated three years ago. This renovation has improved conditions and relieved the major flooding issues that were present. There are still some problems with leaking plumbing. At present we can accommodate 50 students in the lab, however, many of our classes have over 50 students. While the lab is minimally adequate, it is far inferior to nursing labs in most SONs. We are looking forward to the new Science Teaching Laboratory building where we will have additional space to accommodate the numbers of students that need to be in the lab at the same time. However, we anticipate a need for more storage space than is currently allocated in the Science Teaching Laboratory building.

Georgia State University Foundation Resources: The BFLSON has numerous foundation accounts including five endowed and three non-endowed scholarship funds, an endowed fund to honor faculty accomplishments, and funds for departmental and alumni activities. The Byrdine F. Lewis endowment, established in 2003, is designated for student scholarships, faculty development, and faculty research. Additional private funds are needed to expand student scholarships and to establish endowed professorships and chairs.

Library Resources: The library resources are adequate for the needs of our students who require access to databases and journals in health care and related fields (e.g. psychology, sociology, etc.). Although some

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additional requests have been made, we are pleased with available holdings. Faculty and PhD students have requested access to OVID, a search engine that provides access to more online journal articles than our current search engine. Karen Wagner, our former library liaison, was very helpful in assisting faculty with library needs. Her interim replacement, Lyn Thaxton, has graciously assisted us with data for this report. See Appendix G2 for the University Library report.

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H. Goals and Objectives

The prioritized goals and objectives are presented in Table H-1. In Appendix H1, the goals, fit with University goals, objectives, rationale, indicators, outcomes and timeline are presented. The goals and objectives are based on the issues identified in this report and on components of our strategic plan (see Appendix H2). The format required for Appendix H1 is not congruent with our strategic plan format. However, faculty did identify key strategic plan program goals and objectives which are included in Appendix H1; the strategic plan goals and objectives presented do not represent all goals and objectives that are in the strategic plan, only the high priority items as identified by faculty. We expect to achieve these goals. In some cases we have already initiated activities to achieve the goals and objectives.

Table H-1 BFLSON Goals and Objectives Category Goal Objectives Key Indicator I. Teaching Goal 1: To implement

excellent nursing programs at the undergraduate, master’s and doctoral levels.

1. To implement an Adult Health CNS/NP program

* The an Adult Health CNS/NP program will begin enrolling new students within one year.

2. To continue to increase first time NCLEX pass rate

* First time NCLEX pass rate will increase to 95% in 3 years.

3. To improve the learning outcomes assessment plan and alumni satisfaction surveys for the graduate programs.

* Revision of the graduate learning outcomes (MS, PhD) and student and alumni forms.

4. To convert the current classroom-based PhD program to a web-facilitated program

The web-facilitated PhD program will begin enrolling students within one year.

Goal 2: To secure resources that enhance faculty teaching and student learning.

1. To identify consistent funding for part-time clinical instructors for student supervision

* A consistent funding source to cover cost of expert part-time clinical instructors will be available.

2. To improve teaching skills among faculty

*Establishment of a teacher instruction enhancement program for new teachers and those with poor student evaluations * Student and alumni evaluation of instructor teaching effectiveness will improve on UG EBI reports, graduate student exit surveys, and graduate and UG alumni

Category Goal Objectives Key Indicator surveys

3. To employ a part-time nurse to supervise student practice in the Nursing Learning Laboratory and coordinate the use of Meti-Man for student learning demonstrations.

* Part-time nurse will be employed to oversee informal student practice sessions and Meti-Man demonstrations within one year.

4. To secure computer rooms for testing.

* An ongoing plan for access to computers for testing will be implemented.

II. Creativity & Scholarly Activity

Goal 3: To increase research and scholarly productivity among faculty members.

1. To increase internal and external research funding among tenured/tenure track faculty

* The 3-year average of research grant funding will increase to $5,000,000 for external funding and $300,000 for internal funding in 3 years.

2. To increase scholarly productivity among all faculty.

* The average for scholarly productivity will increase by 25% in three years (i.e. 21 refereed publications, 10 scholarly works, 63 presentations)

III. Service Goal 4: To support opportunities for faculty to provide service to the University, the profession, and the community.

1. To support faculty in providing service to the University

The number of faculty serving on college and University committees, work groups, and task forces will remain constant.

2. To support faculty in providing service to professional nursing organizations.

The number of faculty serving on boards, committees, and task forces for professional nursing organizations will remain constant.

3. To support faculty in providing service the community

The number of faculty serving on boards, committees, and task forces for community organizations will remain constant.

4. To support the Health and Wellness Collaborative

The Health & Wellness Collaborative will maintain the number of programs it provides to the community.

In summary, the BFLSON offers an excellent education to UG, MS, and PhD students. The dedication and expertise of the faculty make this education possible. We are proud of our accomplishments and those of our students and alumni. We look forward to continuing our quest to educate nurses who make a significant contribution to the health of those they serve.