Registered nurses represent the largest health profession with approximately 3.1 million members, according to the U.S. Department of Labor Statistics. There are few, if any, aspects of healthcare delivery that are not dependent on nurses, who in turn substantially impact patient, systems and population outcomes. Yet despite decades of dialogue, advocacy and compelling evidence, educational preparation for professional nursing remains fragmented with only 55 percent of RNs holding a baccalaureate degree or higher.
Complicating the matter is the fact that regulatory scope of practice, established through the RN license, is not differentiated by education level. All graduates of entry-level nursing programs take the NCLEX-RN licensing examination; the test only assesses the minimum technical competency for safe entry into basic nursing practice, according to the American Association of Colleges of Nursing. The test does not acknowledge differences between graduates of different programs, measure performance over time or assess the knowledge and skills a nurse developed through a baccalaureate program.
Therefore, entry-level nurses are differentially prepared to practice when they start their careers based on their education. Research suggests increasing proportions of baccalaureate prepared nurses results in decreased patient mortality, failure to rescue, length of stay and readmission rates. Based on the growing evidence and consensus among thought leaders in nursing and healthcare, the Institute of Medicine — now the National Academy of Medicine — recommended in its landmark Future of Nursing Report that at least 80 percent of RNs hold the minimum of a baccalaureate degree by 2020.
This article is sponsored by Capella University.
The need to advance one's nursing education and healthcare employers' need to facilitate advancing nursing education present significant challenges. While practicing nurses may be highly motivated to return to school, time availability tends to be scarce due to professional and personal responsibilities. Cost is also a barrier, which is oftentimes added to the burden of increasing student debt from previous degrees. In addition, nurses logically gain knowledge, skills and competencies through their practice and commitment to continuing education necessitated by the dynamic nature of the practice environment. Thus, there is a psychological barrier to the specter of sitting through classes learning content that may have been mastered long ago. This latter issue is often perceived by experienced nurses as disrespectful as it negates their real-world experiences in favor of academic learning.
What if There was a Better Way?
Higher education, including nursing, must evolve toward more efficient, cost-effective models. In the distant past, nurses returning to school for a bachelor's degree were required to repeat in-hospital clinical practice experiences, even though their RN license demonstrated competency in entry-level clinical practice. Eventually, schools granted registered nurses transfer and prior learning credit for significant portions of baccalaureate education. While nursing has been moving toward a more streamlined path to baccalaureate education for RNs for some time, traditional academic models and practices have hindered further progress.
Traditional education programs are divided into credit hours, a measure that equates to a number of contact hours spent in a classroom with a professor in a given week. Online learning shook up this definition, but regulators and accreditors settled on a loosely seat time-in-a-classroom equivalency as a standard. The credit hour has a storied history. Developed shortly after the turn of the 20th century, the credit hour was established by the Carnegie Foundation as a way to determine which educators would be eligible for their new pension program. It was simply a way to measure volume of time spent working. However, it quickly became a simple and useful organizing concept that higher education literally built itself around. Today the credit hour is central to everything from admission requirements, financial aid eligibility, tuition rates and faculty productivity.
In a very real way, the credit hour has emerged as a unit of learning. However, there is little evidence that contact hours in a classroom or online equate to learning. Time, content and student ability are fixed in a credit hour model. Content X is presented and knowledge and skills related to it are evaluated over two weeks, whether the student could have mastered the content by the middle of the first week or would need an additional week to do so. So while the challenges of the credit model have long been acknowledged, alternatives have remained elusive.
The Revolutionary Education Model
Capella University has been a leader in innovative competency-based education. Capella's continuing effort to be the most direct path between education and career success led to its pioneering efforts in direct assessment degree programs. Capella University refers to its direct assessment learning format as FlexPath. Direct assessment severs learning from the constraints of the credit hour allocation and — as the Capella name implies — allows for flexible learning where students decide when they are ready to demonstrate a particular competency. If students have achieved expertise in an area through their professional practice or continuing education, then they can proceed to demonstrate that competency in a highly rigorous assessment that reflects the real world challenges of their profession. For areas in which students have little prior learning, they access resources and devote the necessary individualized time to prepare to demonstrate a competency. All of this is done with significant and substantive engagement with faculty and academic support team members. The result — a highly personalized learning experience that can mean less time to degree completion and cost savings due to per session pricing.
The School of Nursing and Health Sciences at Capella University launched its RN-to-BSN completion program in the FlexPath model in early 2016. RNs choosing Capella for their baccalaureate education now have a choice between two online learning formats: its credit-based GuidedPath option and FlexPath. The right option depends on a host of factors including motivations, amount of professional experience and preferred ways of learning. Both options lead to the same degree and rely on the students' ability to demonstrate the same competencies and outcomes.
FlexPath is a revolutionary approach to nursing education. If a nurse has extensive experience in quality improvement, he or she can efficiently demonstrate competency in that area and focus time on learning new areas such as informatics. That nurse can choose from a variety of resources to learn informatics that meet his or her specific needs. In addition to the time and cost savings, there is great potential for an enhanced learning experience as research in adult learning science suggests that control and self direction in the learning process is important.
FlexPath offers nurses the added ability to manage their personal and professional lives in a way that enables accomplishment of goals related to multiple competing priorities. When they get to decide when things are due and when to focus on school, the ability to successfully navigate such immutable responsibilities like participation in a Joint Commission survey, completion of staffing schedules and unexpected work days is greatly enhanced. Plus, a week that includes a child's soccer game, piano recital and college application deadline can be managed while maintaining successful academic progression.
On the Cutting Edge of Healthcare
While the evidence that supports the return on investment of baccalaureate education for an organization's nurses is strong, it is still a costly expenditure for hospitals and other healthcare organizations. The RN-to-BSN FlexPath option not only provides employers with an affordable option to boost patient and systems outcomes, it lowers the opportunity costs to employees, which could translate into both higher productivity and job satisfaction. The healthcare market is showing great interest in the FlexPath model as administrators realize such innovation supports their needs that are challenging to meet. The FlexPath model resonates with nurses and nursing leaders. It is not uncommon to hear, "This just makes sense — why haven't we done this before?"
Thus far, feedback from students and faculty has been extremely positive. The option is an exciting step in the continued evolution of nursing education. The model solves some long standing and seemingly recalcitrant challenges. FlexPath RN-to-BSN is just the latest example of Capella's commitment to be the most direct path between education and career success, which in this case translates into the safety and quality of our nation's healthcare.
To find out more about how Capella partners with healthcare employers, visit nursingtrack8020.com