The BSN was implemented in the mid-1970s and was originally housed in the College of Education. Its mission is to provide an accessible, professionally relevant, and academically challenging degree program for the RNs in the 16 counties of southeastern Ohio.

The RN to BSN Program is taught on all six of Ohio University's campuses by a faculty of eight who are academically housed in Athens, but who live closer to several of the regional campuses. The use of the Ohio Learning Network, especially the microwave and compressed video interactive distance classrooms, in combination with travel among regional campuses has enabled the faculty to deliver the program to a population that is widely dispersed geographically. The receipt of a TIPS grant by a faculty member to develop the School's first Web-based course begins the use of another program delivery mechanism.

The majority of the RNs who enter the School are graduates of local community colleges and hold the associate degree as the prelicensure preparation. The prototype learner in the program is female, 30 to 36 years of age, has a family, and has held a full time position in an acute care agency for 10.5 years. Approximately 18% of these RNs were LPNs (licensed practical nurses) prior to entering the prelicensure associate degree program. While 50% of the RN to BSN students have attended only one postsecondary institution prior to their enrollment at Ohio University, the other 50% have attended several postsecondary institutions. These individuals have spent their academic life in the maze of transfer credits, course equivalency evaluations, and the tightly organized structure of prelicensure nursing programs. Over the past three years this student body mix has been challenged with an increasing number of individuals who more closely resemble the traditional college student. These individuals have completed the prelicensure associate degree program, taken the licensing examination, and immediately continued the pursuit of the BSN. Their clinical confidence and experiences are less than that of the program's prototype learner. Classroom dynamics have altered with the affect on learning unclear.

1998 Assessment Report, June 1998, page 2

The quality of any program, be it in education, health care, or the production of widgets, can be assessed by answering four major questions:

1. Is the program meeting its goals?

2. Is the program maintaining set standards?

3. Are the clients satisfied?

4. Are the client outcomes positive?

Each of these questions will be addressed in this third of annual assessment reports

with the specific items related to Ohio University outcomes assessment being included under item #4.

Is the program meeting its goals? The driving goal of the School of Nursing is to provide a baccalaureate program of high quality for professionally active registered nurses that meets both the individual RN's needs and the needs identified by relevant segments of the health care industry. To meet this goal the program must:

1. address the learning desires of the RNs who choose to attend the program.

2. be delivered in such a way that employed adults can attend and complete the necessary course work.

3. contain the content and skills identified as essential by the employers

of these RNs and by the relevant accrediting bodies.

Each of these is addressed in order.

Responses to surveys of seniors/graduates conducted by the School and by the Office of Institutional Research (OU Career and Further Education Study) indicate that this goal is being met. The latest data collected by the School in the senior capstone course (March 1998 and May 1998) mirrored previous data. Responses to the relevant item follow:

1998 Assessment Report, June 1998, page 3

Data from the Office of Institutional Research (1996) indicate:

and OU graduates in general but lower than SON data of past two years)

OU prepare for career goals: 80% (Higher than other CHHS graduates

and OU graduates in general and comparable to SON data of past two years)

OU prepare for additional academic work: 75% (Comparable to other CHHS graduates

and OU graduates in general and lower than 1995 SON data but comparable to 1994

SON data)

3. There are four indicators of the School's success in addressing the content deemed essential and appropriate for a baccalaureate in nursing.

3.1. The School's Advisory Council reviews the curriculum on a regular basis and provides input. No revisions were recommended at the fall 1997 meeting.

3.2. The School is currently accredited by the National League for Nursing with the next on site visit scheduled for the fall of 1999.

3.3. The School applied for and received "preliminary approval" status through the Commission on Collegiate Nursing Education. This approval is based on written materials and is valid until a site visit is scheduled.

1998 Assessment Report, June 1998, page 4

3.4. The new School Nurse Certificate/License Program was approved by the Ohio Department of Education upon its initial application.

Is the program maintaining set standards? Yes, based upon the input of the individuals and agencies listed in the immediately preceding item. During the 1998-99 academic year the School will be writing the self-study in preparation for the fall 1999 national accreditation site visit. In addition to curriculum, other factors reviewed will be administrative structure, faculty credentials and activities, and relevant characteristics of the university.

Additionally, the School was reviewed by the University Curriculum Council this spring with one criterion being judged as "exceeds expectations" and the remainder of the criteria judged as "meets expectations."

Are the clients satisfied? Yes, information compiled through both formal and informal means indicate that the majority of the learners in the RN to BSN Program are satisfied with the various components of the program. Surveys of the graduates completed one year following completion of the senior courses in the major indicate that

89% of the learners would recommend the program to their colleagues.

An evaluation of the advising within the School was piloted during the 1997-98 academic year. The return rate was low (17.6%, 44 out of 250 mailed with DARS) with

the overall impression of the faculty's advising being rated as 3.64 (on a 5-point scale)

and the impression of the individual advisor being rated as 3.74 (on a 5-point scale).

Revisions in the form have been made, and forms will be sent with the fall 1998 DARS.

Are the client outcomes positive? The specific questions posed by the Ohio University Annual Assessment guidelines fall into this area of program evaluation

and will be addressed specifically.

The goals for student learning are developed by the faculty within the frameworks established by two national accrediting bodies, i.e. the National League for Nursing (NLN) and the American Association of Colleges of Nursing (AACN). The NLN's Criterion 14 addresses the evaluation of educational effectiveness. Each program is required to evaluate four required outcomes (critical thinking, communication abilities, therapeutic nursing interventions, and patterns of employment). Additionally each program chooses and evaluates two optional outcomes from the provided list. The School has chosen to evaluate the learners' satisfaction with the program and the "nursing unit defined." The latter outcome focuses on specific aspect of the unit that is closely related to the School's mission. We have chosen to address the specific learning needs of the adult RN to BSN population who is dispersed across a broad geographical region.

1998 Annual Assessment, June 1998, page 5

The Council of Collegiate Nursing Education (CCNE) is the accrediting body with organizational ties to the American Association of Colleges of Nursing. This body reviews only those schools of nursing that offer the baccalaureate, masters, or doctoral degree programs in nursing (as distinguished from the NLN which reviews nursing programs from the level of practical nursing through prelicensure diploma, associate degree, and baccalaureate degree to master's level education). Its curriculum oriented criteria closely follow the information in the AACN's 1986 document, The Essentials of Baccalaureate Education for Professional Nursing Practice. The areas identified in the 1986 Essentials

document were used in the development of the School of Nursing's learner outcomes. The Essentials document has been revised (March 1998) and will be reviewed by the faculty during the 1998-99 academic year.

Based on the above two documents the end of program objectives continue to be:

The School of Nursing provides the RN with the opportunity to develop an

These goals have not been modified within the last year. The faculty have devoted their attention to identifying the mechanisms for evaluating these specific outcomes.

2. How do you assess student learning? What testing instruments, methods and processes do you use to collect assessment data? Have these assessment activities been modified since last year?

(a) achievement of the core knowledge, (b) appropriate use of that knowledge in clinical decision making, and (c) comparison of data in both areas to identified norms or standards.

Each of the three areas of evaluation can be addressed from the individual perspective and the aggregated cohort perspective.

The first area of evaluation (achievement of the core knowledge) is assessed through the grades received on assignments specific to each outcome. Course assignments are consistent across all sections, all faculty, and all learners within a given cohort. Learners receive input regarding individual performance and aggregate performance is assessed through information regarding the number of individuals who must repeat courses.

1998 Annual Assessment, June 1998, Page 6

Learners must earn a grade of "C" (75%) in each major course, or it must be repeated prior to enrolling in the next course in sequence.

The second area of evaluation (appropriate use of that knowledge in clinical decision making) is evaluated through the faculty's evaluation of the learner's interactions with clients. This evaluation is managed through a combination of direct observation of practice by the faculty and input sought from preceptors in the clinical agencies. These evaluations provide the learner with individual evaluations and evaluations completed by the preceptors provide a mechanism for a sense of how the group is performing.

The third area of evaluation is the comparison of information relevant to the aggregate performance of Ohio University's RN to BSN students to identified norms or standards. At the present time data have been collected in relation to critical thinking.

The underlying skills of RN to BSN students are assessed at the beginning and the end of the sequence of major courses as follows:

1. NRSE 295 (orientation taken prior to beginning of major courses): California Critical Thinking Disposition Inventory which is designed "to estimate the degree to which one is disposed toward critical thinking" (California Academic Press CCTDI manual).

2. NRSE 300 (first nursing major course): California Critical Thinking Skills Test which "tests skills necessary for succeeding as a critical thinker" (California Academic Press CCTST manual).

3. NRSE 455 (last nursing major course): Repeat administration of the California Critical Thinking Test.

Initial and follow-up data have been collected on two cohorts of learners.

Cohort #1 completed NRSE 295 in February of 1996, NRSE 300 in the spring quarter of 1995-96, and NRSE 455 in March of 1998 while Cohort #2 completed NRSE 295 in August of 1996, NRSE 300 in the fall quarter of 1996-97, and NRSE 455 in June of 1998. Given the specifications of the analysis service these data were sent as a batch. The analysis will

be returned in late July 1998 and will provide aggregate data and individual data if students choose to have the information.

Faculty are in the process of determining how to evaluate the application of critical thinking skills in the clinical arena. Different combinations of learner portfolios and case simulations are being evaluated.

Once the statistical analysis of the critical thinking data have been received

they will be sent to the Program Evaluation Committee for an initial discussion of: "What do these mean?" The results of this discussion will be taken to the full faculty for further discussion of the data and decisions regarding policy.

This is the same process that has been used in assessing other areas of the

program, e.g. specific items from the College's evaluation of teaching instrument plus student generated comments relevant to a course, are reviewed by the Program Evaluation Committee. Consistent concerns are relayed to the Curriculum Committee which reviews

1998 Annual Assessment, June 1998, page 7

the issue and brings any necessary recommendations for course/curriculum revisions to the full faculty.

Thinking about the third area of evaluation (comparison of local data to norms/standards) has raised some questions that need to be addressed across all cohorts. The basic notion of using standardized critical thinking measures at three points in time for comparative purposes is based on an underlying assumption that the cohort being assessed at each of those three times is comparable. Given the nature of adult learners (AKA nontraditional students) this is a very shaky assumption. Adult learners move in and out of the program more frequently than traditional students. It may be that no more than one-half to two-thirds of a group that started at point X will finish at point Y. The degree of faith (or lack thereof) in the assumption of comparable groups has implications for all grouped measures of student learning in the School of Nursing; consequently, an essential task is to create a picture of the learner stream. This task is being completed during the summer of 1998.

Qualitative data indicate that the RNs are accomplishing their goals. Learners are asked in the orientation class, "What are the reasons for your returning to school?" The majority (75%) of the RNs state they are returning to meet personal learning goals and/or to gain the credentials necessary for advancement in the discipline. When asked a variation of this question at the end of the program, the majority (82% over the past five years) indicate that the program met their needs. The faculty are in the process of designing a questionnaire that would request more specific information in this area.

1998 Annual Assessment, June 1998, page 8

The following activities related to each program goal have been identified as being important and are in various stages of development:

1.1 Data on standardized instruments measuring critical thinking disposition and skills are collected at entry and exit of major courses. Improvements related to critical thinking cannot be considered until the analysis of the data collected to date have been received and reviewed.

1.2 Identified assignments within major courses which have been designed to enhance aspects of critical thinking are to be tracked. Should this tracking/measurement be done through learner portfolios OR should grades on assignments plus pre/posttest case analysis serve as the indicator?

2.1 Assumption has been that performance in theory/clinical courses which includes assessment/planning/implementation/evaluation of nursing care has been sufficient.

2.2 Discussion of how to achieve more consistent information that can be shared with all faculty is occurring.

3.1 Includes self-expression (written, oral, nonverbal), with colleagues (written,

poster presentations), and as an intervention (teaching, counseling).

3.2 Skill in written self-expression is documented in pre/posttest style through

use of philosophy of nursing paper written in first and last course in major courses. Need to create a process whereby a selection of these paired papers can be assessed by an external reviewer.

3.3 Advantages and disadvantages of individual learner portfolios are being

evaluated.

4.1 Need to devise mechanism to receive input from employers

5.1 There is considerable group work in the major courses that mimic the

tasks that occur in cross discipline groups in the work setting. There is

no consistent method of assessing achievement in this area.

1998 Annual Assessment, June 1998, page 9

5.2 The improvement of the preceptor selection process will be completed and activated. A way of assessing learner satisfaction with the two systems is

being developed. Discussions regarding the harder task of measuring the assumed impact on learning are underway.

A grid comparable to the one on page 10 is being developed.

No changes in the academic program will occur during the next year other than those already mentioned. The year will be devoted to the self-study that is required by the professional accreditation process. As the faculty look to that process the completion of the table outlined below will assist in a clearer understanding of our expectations in learner outcomes with the expectation that program revisions will occur during 1999-2000 based on what is learned during the 1998-99 academic year.

School of Nursing, 1998 Annual Assessment, page 10

Required Outcome (example): COMMUNICATION is defined as a process by which messages are exchanged between people through a common system of symbols, signs, or behavior.