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Other___________________________________________________________________________ , Text follows. f University Microfilms international IMPLEMENTATION AND EVALUATION OF A FEASIBILITY STUDY FOE A PROGRAM LEADING TO A MASTERS OF SCIENCE IN NURSING AT SAGINAW VALLEY STATE COLLEGE By Sachiko Kanegae Claus VOLUME I A DISSERTATION Submitted to Michigan State University In partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Adult and Continuing Education A u g u s t , 1986 Copyright by SACHIKO KAHKGAE CLAUS 1986 ABSTRACT IMPLEMENTATION AND EVALUATION OF A FEASIBILITY STUDY FOR A PROGRAM LEADING TO A MASTERS OF SCIENCE IN NURSING AT SAGINAW VALLEY STATE COLLEGE By Sachiko Kanegae Succe ss ful progr am development: rests upon a c o mp re he ns iv e accou nt as In hi gher educat io n f eas ibi li ty study a vari ety of factors groups. Claus related a basis resour ce s clima te the program* therefore to support to insure information; that is properly used. First, to de si gn that the and o r g an iz at io na l It Valley State The purpose of this study was and that it two-fold. for c on du ct ing a co mp re he nsi ve the pro posed gr adu at e College, is important efficiently; feasibility study and then apply the model fe a si bi li ty of and study provide valid and useful it is impleme nte d a model into for decisions progr am is needed whether or not sufficient exists takes to all constituent A f ea si bi l it y study provides to whet her or not a proposed that and second, to deter min e the program at Saginaw to evaluate the process and outcome. School Valley State gra du ate Nursing of Nursi ng and Allied Health College program (MSN). (SVSC) leading has proposed to a Mast ers The study was Sciences to est ab li s h of Science conducted area of SVSC during J a n u a r y - J u n e , 1986. at over the In order Saginaw a degree in fifty-mile to obtain Sachiko Kanegae Claus qua li ta ti ve as well stituent groups as qu an ti ta ti ve the study applied three data c o l l e c t i o n methods: and Social the model of the results methods re vea le d and that support the proposed gr adu ate Task Force Group, there of all three data is suff ic ien t among all inc luded Survey, bility study con du ct e d C om mit te e revealed that colle ct ion interest, the co nst it uen t groups for program. The e v a l u a t i o n of the process and the Joint that the con­ Indicators. An aly sis resources, data from all outcome of by a set of standards on Standards the feasi­ iden tif ie d by for Ed u ca ti on al E v a l ua ti on the m a j o r i t y of the standards were met. ACKNOWLEDGEMENTS I am indebted to many individuals for great contribu­ tions made to various aspects of this study* I would like to acknowledge their names with deep appreciation. First to Dr. James E. Snoddy, my advisor and committee chairman, for his personal interest, guidance, and encour­ agement throughout the doctorate program and this research. I would also like to thank the other members of my disserta­ tion committee Dr. Bruce D. Cheney, Dr. S. Joseph Levine,-; and Dr. Max R. Raines, tributions for their valuable insights and con­ to this study, and their guidance and encourage­ ment during the course of my graduate studies. I am also indebted to Dr. Crystal M. Lange of Saginaw Valley State College for her continued inspiration and support throughout my graduate career. Her enthusiasm and dedication toward' the advancement of nursing education, and her interest in my professional development made this study possible. Many thanks to my fellow faculty members of the Depart­ ment of Nursing as well as administrators, faculty and staff of Saginaw Valley State College for their cooperation and support for the completion of this study. Special thanks are due to Miss Terry Fisher who labored many houcB typing this manuscript. 4 ii I am appreciative to ray family members both In the United States and in Japan for their belief in education and continuous encouragement. Finally, I am thankful to my husband Richard, who has been a continuous source of motivation and inspiration for me to complete my doctoral program. His patience, his sacrifice and loving support made everything possible. ill TABLE OP CONTENTS Page CHAPTER I: INTRODUCTION...... .......................... I Designing A Comprehensive Feasibility Study . . . . . Background of This S t u d y .............................. Evaluating the Process and Outcome of the Study . . . Purpose of the Study . . . . . . . . . . . . . . . . The Research Q u e s t i o n s ............................. Definition of T e r m s .................................... A s s u m p t i o n s ........... Limitations of the Study .................... . . . . . 3 6 10 11 12 15 18 19 CHAPTER II: 20 I. THE REVIEW OF THE LITERATURE: HEEDS ASSESS­ MENT a . * . . . . . . . . . . * . . . . . . . A. B. III. 21 What is a H e e d ? .............................. What is the Definition andPurpose of a Needs Assessment? . . . . . . . . ......... Models of Needs Assessment ............. Needs Assessment Methods .................. 25 27 32 The Group M e t h o d ................................ The Survey M e t h o d ................................ Social Indicators ................................ Evaluation of Needs Assessment .................. 33 35 37 39 REVIEW OF THE LITERATURE: THE TRENDS IN THE 'U.S. HEALTH CARE SYSTEM THAT WOULD AFFECT NUR S ­ ING— IMPLICATIONS IN THE DEVELOPMENT OF A MSN P R O G R A M ........................................... 41 NEEDS ASSESSMENT LITERATURE RELEVANT FOR PLAN­ NING GRADUATE PROGRAMS ......................... 47 C. D. II. THE REVIEW OF THE L I T E R A T U R E ............. Needs Assessment in Planning a Graduate Pro­ gram .............................................. Conducting a Feasibility Study for a Ma’ster's Degree Program in Nursing ....................... S u m m a r y ........................... CHAPTER III: 21 47 49 54 METHODOLOGY .............................. 55 S e t t i n g .................................................. P o p u l a t i o n .............................................. Needs Assessment Methods .......................... 59 64 65 iv TABLE OF CONTENTS (Cont'd.) Page A. The 1. 2. 3* 4. Task Force Group M e t h o d ....................... The Community Task Force Group . . . . . . . Nursing Faculty Task Force Group . . . . . College-Wide Faculty Task Force Group . . . SVSC Nursing Alumni Task Force Group . . . ............ 65 . . . . 70 73 73 73 . . . . . 74 B. The Social Indicator Method C. The Survey M e t h o d ................................... 75 1. Survey of Registered Nurses.. .................. Sampling Design . . . . . Determination of Sample S i z e .............. S u b j e c t s ..................................... . . . . . Instrument ....................... Procedure .............................. Questionnaire Retrieval . . •........... . 76 -76 76 7B 79 80 81 2. The Survey of the Currently Enrolled Nursing Students . . . . . ........................ Instrument ............. P r o c e d u r e s ............. 3. 84 84 84 Survey of the Potential E m p l o y e r s ........... 85 I n s t r u m e n t ................................... P r o c e d u r e ................................... 85 87 Methodology for Evaluation Phase I: Phase II: Phase III: . . . . . ......... . . . Evaluation of the Preparation Phase . Evaluation of the Implementation P h a s e ................................... Evaluation of the O u t c o m e ............ 88 88 89 89 Summary of the.M e t h o d o l o g y ............................. 91 CHAPTER IV: 92 R E S U L T S ................................... Section One: The Results of the Needs Assessment . . The Results of the S u r v e y s .............. ............... The Results of the Questions that Only Apply to the Registered Nurses . . . . . . . . . The Responses to Questions Common to Both RNs and Nursing Students . . . . . . . * . * . * . . . . . . v 92 93 95 102 TABLE OF CONTENTS (Coat'd.) Page Results of the Questions that Only Apply to the Generic Nursing Students .............................. Summary of the Results of the Registered Nurse and Nursing Student Surveys ................................ The Results of the Potential Employer Survey . . . . Summary of the Potential Employer Survey ........... Results of the Tasks Force G r o u p s ............ Community Task Force Group: Session I (December 5, 1985 ) ....................................................... - The N e e d s ......................................... - R e s o u r c e s ................................. 131 134 - Resources Needed for the Proposed Program . . . - The Manner In Which the Program ’?ill be O f f e r e d ........................................... - Determining the Market Needs ..................... - Session - Session 117 118 130 131 131 Community Task Force Group: Session II (January 2, 1986 ) ....................................................... SVSC Nursing SVSC Nursing 113 138 141 142 142 Alumni Task F o r c e ............... 144 Faculty Task Force Group ................ 150 I (January 15th for 1 1/2Hours) . . . . II (February 12,- 1986 1 1/2 Hours) . . 151 154 SVSC College-Wide Faculty Summary of the Results of Method . . . . . . . . . Social Indicators Method . Task Force Group ......... the Task Force Group . . . . . . . . . . . . . . .............................. 162 163 - Characteristics of the Population in 18 County A r e a ................................................ - Socioeconomic Data . . . . . . . . .............. 165 167 United Way Needs Assessment - ........................... Background of the S t u d y ......................... Survey Findings .................................. Health Care Agencies Within 18 County Area . . . Local, State and National Statistics Relative to Registered Nurses .............................. Summary of Social Indicator Method . . . . ............ Section Two: The Results of the Evaluation of the Needs A s s e s s m e n t ......................................... vi 158 169 169 170 172 173 178 179 TABLE OF CONTENTS (Cont'd.) Page t Phase I: Phase II: Phase III: Evaluation of the Preparation Phase of the Needs A s s e s s m e n t .............. Evaluation of the Implementation P h a s e ......................... Evaluation of O u t c o m e ................ The Summary of the Results of the Evaluation CHAPTER V: PART I: I. II. DISCUSSION . . . . ................................ IV. 201 202 203 Potential Students . . . . . . . . . . . . . . The C o l l e g e ........................................ 2173 215 Potential Employers ............................... C o m m u n i t y .......................................... PART II: I. II. III. 191 194 PRIMARY RESEARCH QUESTION: ARE THERE SUB­ STANTIAL NEEDS AND RESOURCES FOR THE DEVEL­ OPMENT OF A MSN PROGRAM AT S V S C 7 ............ - Steps for Approval of a New Graduate Program at S V S C ......................................... - Steps for Approval of a New Graduate Program at State Level . . . . . . . . . . . . . . . III* IV. 179 HON HELL HAS THE STUDY C O N D U C T E D ? ......... Was the Information Reported Appropriately? . . Has the Study Carried Out Effectively? . . . . Here the Rights of the Persons Affected by The Study P r o t e c t e d ? .................. Has the Study Produced Sound Information? . . . S u m m a r y ..................................................... 222 222 227 233 238 239 246 254 258 269 CHAPTER VI: CONCLUSIONS .............................. 270 APPENDIX A: Letter to the Members of the Community Task F o r c e ................................ 281 APPENDIX B: Memo to Nursing F a c u l t y ................... APPENDIX C: Documents Related to Requesting Approval from Institutional Review Board Saginaw Valley State College ........... vii 282 283 TABLE OF CONTESTS (Coat'd.) Page APPENDIX D: Documents Concerning Protection of Human Subjects - Michigan State University . . 295 Steps for Estimating Sample Size for the Registered Nurse Survey . . . . . . 301 APPENDIX F; Nursing Education Survey ................ 305 APPENDIX G: Letter of Transmittal to Registered Nurses ..................................... 312 Eleturn Envelope and Post Card for Sur­ veys ....................................... 313 APPENDIX E: APPENDIX H: APPENDIX I; Commuication with Participating Agency . 314 APPENDIX J: Letters to Directors of Nursing Explain­ ing the Procedures for the Registered Nurse Survey .............. . . . . . . . 316 Number of Questionnaires Distributed/ Returned (RN Survey) . . ................ 317 APPENDIX L: Nursing Student Survey 318 APPENDIX K: Letter of Transmittal to .. 324 APPENDIX N: Letter of Transmittal to Nursing Stu­ dents . . . . . . . . . . . . . . . .. 325 Institutional Survey 326 APPENDIX Ks APPENDIX 0: .................. RN Students ..................... t Letter of Transmittal to Director of N u r s i n g ................................ 332 APPENDIX Q: Evaluation Form for the Dean ........... 333 APPENDIX R: RN Survey: 335 APPENDIX S: Comments by the Respondents of the Nursing Student Survey .................. 354 Comments by the Respondents of the .............. Potential Employer Survey 358 The Steps for Deriving the Total Number of the BSNs and Potential BSNs in Saginaw's Surrounding Eighteen County A r e a ....................................... 360 APPENDIX P: APPENDIX T: APPENDIX U: Respondent Comments viii . . .. TABLE OF COHTEHTS (Coat'd.) Page APPENDIX V: Letter of Support from Vice President for Academic Affairs - Saginaw Valley State C o l l e g e ........................... 362 Letter' of Support from the President of Saginaw Valley State College ........... 363 Evaluation Form Completed by the Dean . 364 R E F E R E N C E S .............................................. 366 APPENDIX W: APPENDIX X; ix LIST OF TABLES Table 1 Page Number of Health Care Agencies Listed by the Michigan Department of Public Health (MDPH) and Schools of Nursing Within 30 Miles and Greater Than 30 to 50 Miles of Saginaw Valley State College, January, 1985 63 2 Questions Addressed by Each Task Force Croup . 69 3 MSN Needs Assessment Questionnaire--Return Rate by the Type of Health Care Agencies (Potential Students - R N ' s ) ..................... .83 E*1 U.l Steps for Deriving Number of Clusters in Each S t r a t u m ........................................... 302 Steps for Estimating the Total Population of BSNs and Potential B S N s ......................... 361 x LIST OF FIGURES Figure Page 1 A Conceptual Framework for Needs Assessment 2 The Process of Needs Assessment Used In This S t u d y .......................................... . . 24 58 3 SVSC and Surrounding 30 Mile and 50 Mile Area . 60 4 Distance Between SVSC and Surrounding BSN and MSN Programs .............................. 61 5 A Schema of the Nominal Group P r o c e s s ....... - 67 6 SVSC and the Surrounding 18 County Area . . . . 7 RN Survey (N“ 291) Interest in the Proposed MSN Program Among Those Qualified Currently or Within Two to Three Tears . ..................... 205 8 Student Nurse Survey (N"97) Interest in the Proposed MSN Program Among Those Who Meet .................................. Qualifications xi 164 207 CHAPTER I: INTRODUCTION A feasibility study is conducted when an accurate pre­ diction is needed as to whether or not a proposed plan would be successful. opment, In the context of educational program devel­ a feasibility study or needs assessment provides a basis for decisions as to whether or not a proposed program is needed and whether or not sufficient resources and cli­ mate exists to support the program. It is important there- ' fore to insure that the study provide valid and useful Information; that it is implemented efficiently; is properly used (Stufflebeam, Nelson, 1985, McCormick, and that it - Brinkerhoff, and p. 179). School of Nursing and Allied Health Sciences at Saginaw Valley State College (SVSC) has proposed to develop a gradu­ ate program leading to a Masters of Science in Nursing (MSN). In order to establish a successful program a compre­ hensive feasibility study was needed. The purpose of this study was to conduct a comprehensive feasibility study for the proposed MSN program with a specific focus on the appraisal of its process and outcome. Although the literature of adult education advocates the use of needs assessment Pennington, 1980, p. (Knowles, 1; Brockhaus, oping an educational program, 1980, p. 82; 198A, p. 233) observations in devel­ indicate that the methodologies used to conduct needs assessment in practice 1 are often Inadequate. Many practitioners resort to a single source of data to conduct needs assessment, utilize only one data collection method* while others Some only assess the learner's needs while Ignoring Institutional and societal needs* Others only resort to a survey which Is often conducted Inproperly. Epstein (1978), a specialist on the feasibility study in planning a graduate program in nursing, laments that feasibility studies are often done to conform to the proper process or to meet the needs of the approving body; and a plan for action Is developed even before the data Is collected; that programs are often initiated based on demonstrable need, but without a clear understanding of the resources necessary for such an undertaking. Because valid and useful information is crucial for making responsive decisions for educational planning, a feasibility study requires a comprehensive design and efficient methodology. 2 DESIGKIMG A COMPREHENSIVE FEASIBILITY STDDY In order to conduct a successful feasibility study various factors should be taken into account including the following (Witkin, 1984, p. 3; Raines, 1977, p. 31): 1. Involving in the study, all who will be affected by the program (consti­ tuent groups). 2. Identifying not only the needs but also the resources to support the program. 3. Identifying a need, both from indi­ vidual and societal perspectives. A number of needs assessment models that take into account the above factors have been found in the literature, some of which are particularly relevant to higher education (Witkin, 1984; Mlsanchuk, 1982; Raines, 1977). These models tend to include more than one data collection method in their designs, providing more valid and useful Information. Three data collection methods commonly used to conduct a needs assessment include the task force group, and the social Indicators (Witkin, 1984, p. 63). the survey, The task force group consists of a group of key informants represent­ ing each constituent meetings, group. During the task force group the group members share their opinions and ideas regarding the proposed program. The survey method utilizes either an interview or a questionnaire to collect informa­ tion. The social indicator method uses existing data, e.g., demographic and socioeconomic data, which are pertinent to 3 the program development. Each model combines one or more of these data collection methods In Its design. In search of an appropriate model to conduct this study three models that are relevant to program development in higher education have been examined. College Model (Witkin, ing Model (Witkin, Model (Raines, 1984, p. 47), a Multicomponent Train­ 1984, pp. 45-47), 1977). They are a Community and a Transactional A model proposed in this study incor­ porated attributes from each of these models in an effort to conduct a comprehensive study. In conducting this study three data collection methods mentioned above were employed: task force group, survey and social lndictorB. Using the Task Force Group Method, four task force groups were formed which represented each major constituent group (i.e., Community, Nursing Alumni, Department of Nurs­ ing, and SVSC College-Wide Faculty). consisted of 7-10 members, and met Each task force group I or 2 times to identify needs, i resources and concerns relative to the proposed program. The Survey Method included a Registered Nurse, ing Student, and a Potential Employer Survey. tered, a Nurs­ Self-adminis­ 16 to 23 item survey questionnaires were distributed to each population sample. The Social Indicator Method included the identification of demographic, socioeconomic and health related statistics of the population in the study area. 4 National, state and local statistics related to the registered nurses with advanced degrees were also Identified. The data collected through these methods were then analyzed in order to deter­ mine the feasibility. 5 BACKCROPHD OF THIS STUDY Saginaw Valley State College primarily to meet dents (SVSC) was founded In 1963 the higher education needs of the resi­ In east-central Michigan. The college offers prehensive array of baccalaureate degrees. also are granted In fields regional demands Statement, 1985). a com­ Masters" degrees for which there Is substantial (Saginaw Valley State College, Mission The Baccalaureate Nursing Program at SVSC was established in 1976 to meet the community demands for baccalaureate prepared nurses. The program has since been accredited by the National League of Nursing in 1982. Today the Department of Nursing Is well established with 120 cur­ rent students and more than 250 graduates. In accordance with the mission of the college, the faculty of the Department of Nursing strives toward the preparation of students as competent professional nurses who serve the interest of the society in the areas of health (SVSC Department of Nursing Philosophy, 1985). Accordingly, the Department tries to adapt to meet the changing needs of the society. Five years ago, the Department conducted a needs assessment survey for the development of a MSN program (SVSC Masters in Nursing Training Grant Application, The Impetus for the development time came from several 1. factors. of the MSN program at that These factors included: The major health care trends of the community that demanded a new set of competencies from the professional nu r s e ; 6 1981). 2. Professional standards and expecta­ tions that specified the type of educational preparation a'profes­ sional nurse leader should have; 3. The lack of MSN programs available within commuting distance; 4. The presence of a substantial number of baccalaureate prepared nurses who would be eligible for the proposed MSN program; and 5. The characteristics of the potential students, namely a. b. c. employed full-time having family responsibilities, and unlikely to commute more than 70 miles one way to an existing MSN program. In the 1981 study, 150 questionnaires were distributed to a potential student pool in the Saginaw area. attained a response rate of 88 percent. The study The results of the survey had revealed a very favorable response from the respondents toward the development of the program (SVSC Master's in Nursing Training Application, 1981 p. 27), Although the needs for the development of a MSN program at SVSC was well substantiated by the survey, the grant was not awarded due to an insufficient number of qualified faculty. Since the previous needs assessment in 1981, the Department of Nursing has made significant progress in various aspects of the program. Four of the eleven full­ time faculty members have been actively pursuing and making significant progress toward the completion of the doctorate. The baccalaureate curriculum has been re-evaluated and 7 strengthened to Improve the quality of the nursing program. The graduates" performance on the State Board examinations has been consistently higher In comparison to graduates of other baccalaureate nursing programs in Michigan (School of Nursing and Allied Health Sciences, 1985). The graduates have been fully employed by a variety .of health care agen­ cies (both locally and outside the area). The employers of the graduates have been highly satisfied with the perform­ ance of the graduates Planning, SVSC, 1986). (Office of Institutional Research and The development of a traditional (. academic nursing environment in SVSC campus is evidenced by an establishment of Sigma Theta Tau, a National Honor Society in Nursing in 1985. The College-wide building expansion program, when it is complete in 1987, will enable the Department of Nursing to be housed in the second floor of Wlctces Hall, with its own classrooms, office space, laboratories, and research facilities. The executive officers, the Dean and the faculty of the Schoo.l of Nursing and Allied Health, feel that the College now has more strength and a better environment for the development of an MSN program than it had five years ago when the previous feasibility study was first conducted. the other hand, On there have been dramatic changes both in the national and local health care system during the past five years. The society as a whole has also experienced a tremendous amount of social and economic change during this period. As the Department of Nursing at SVSC intends 8 to >■*. develop a successful MSN program In Che near future, another feasibility study was required because the previous study was limited to a survey of the potential students. The purpose of this study was to update and expand the scope of the feasibility study. 9 EVALUATING THE PROCESS AHP ODTCOME OP THK STUDY Because the needs assessment provides a basis.for cru­ cial decision making regarding the program development, it consumes valuable resources, and it is important to insure that the study was conducted efficiently and appropriately (Stufflebeam, McCormick, 179). Brlnkerhoff, and Nelson, 1985, p. To assess the accuracy and efficiency of the study, both its process and outcome have been evaluated. The evaluation was conducted according to the standards estab­ lished by the Joint Committee of Standards for Educational v , Evaluation (1981). The feasibility studies conducted for the development of a MSN program by other colleges were also reviewed in order to make comparisons with the method­ ology used for this study. Issues to be taken into consideration during the course of the feasibility study were also identified and described. These Included: 1. The organizational culture should be understood by the researcher who con­ ducts the needs assessment, 2. A planned change strategy should be utilized in conducting the feasibility study, and 3. Upon determination of the feasibility of the proposed program, the needs of the individual and society must be carefully weighed. These issues have important implications during the process of the feasibility study and eventually may affect the efficiency of the study as well as accuracy of the information. 10 PPRPOSK OF THE STPDY The purpose of this study was twofold; and conduct a comprehensive posed MSN program at SVSC, first to design feasibility study for the pro­ and second, to evaluate its process and outcome in the hope of contributing toward the improvement in practice of needs assessment. Specifically, the objectives of the study are to: 1. Describe the design of a comprehen­ sive feasibility study, 2. Describe the methodologies and their rationale for conducting the study, 3. Describe the methodologies used to evaluate the process and outcome of the study, 4. Identify the needs and resources of each constituent group for the pro­ posed MSN program, 5. Appraise the efficiency and a p p r o p r i ­ ateness of the model used, 6. Identify the usefulness of the infor­ mation in determining the feasibility of the program development, and 7. Identify issues in conducting a feasi­ bility study. The dissertation would result not only in identifying the feasibility of the proposed program, approach and suggestions useful for other adult educators conducting similar feasibility studies. 11 but also present an THE RESEARCH QUESTIONS The primary research questions for this study are as follows: • Are thdre substantial needs and resources for the development of a MSN program at SVSC? a How well was the study conducted? The following sets of subsidiary questions were addressed In order to answer each of the primary research questions . Are there substantial needs and resources for the develouent of a MSN Program at SVSC? I. Potential Students A. How many registered nurses with a BSN as their highest degree are employed in the health care agencies in the 50-mile radius of SVSC? B. What proportion of the above population is eligible and interested in enrolling In the SVSC Graduate Nursing Program within the next 2-3 years? t II. C. What are the characteristics of potential students who are interested in the proposed MSN program? D. What type of MSN program is desired by the potential students? E. What are the attitudes and concerns of the potential students toward the proposed pr o ­ gram? The College A. Will there be a sufficient number of faculty prepared to teach in the proposed program? 12 III. B. Is there a commitment on the part of the administration to provide necessary finances to support the program during planning and Implementation? C. Are existing clinical resources in nearby communities adequate to provide graduate level experiences? D. Is there another MSN program in the area similar to. the one proposed by SVSC? E. Are there sufficient campus facilities and learning resources to meet the needs of the proposed program? F. Hhat is the process of obtaining approval from the college for the development of a new graduate program? What is the procedure of approval at the state level? G. How do other faculty in the college feel about the development of a MSN program? H. Are the undergraduate nursing faculty committed to the development of a MSN pro­ gram? Potential Employers A. What is the nature of the job market for MSN graduates in the area? 1. What are the attitudes of the potential employers toward the graduate nursing education? 2. Are there vacancies or unfilled positions that require MSN backgrounds? 3. Would positions requiring a MSN degree be created if there were appropriately pre­ pared candidates to fill them? 4. What functional role(s) would be. needed the most: administrator, teacher, or clinical specialist? 5. Which clinical specialty would be in most need of a master prepared nurse? 13 IV. Community A. What are the social Indicators of the surround­ ing communities that would show the needs for services by MSN prepared nurses? B. What are the opinions of community representa­ tives regarding the proposed program? How well was the study conducted? I. II. III. IV. V. Was theinformation reported appropriately? Was the study carried out efficiently? Were the rights of the persons affected by the study protected? Has the study produced sound information? How does this study compare to feasibility studies conducted for other MSN programs? 14 DEFINITION OF TERMS The following definitions are supplied to provide a common understanding of key concepts In this study. BSH--A registered nurse with a license to practice nursing In the State of Michigan and a graduate of a baccalaureate nursing program who has not obtained a higher nursing degree. Characteristics of Those Interested in the Proposed Master's Program— These char­ acteristics include: demographic data (i.e., age, sex, marital status, number and age of dependents, travel distance from home to SVSC, etc.); educational background (I.e., years since completion of BSN, or expected date of BSN comple­ tion, type of initial nursing program, etc.); professional background (i.e., current licensure as RN, years of experience in nursing, type of specialty, current position, etc.); and preference related to the proposed master's program (I.e., full- or part-time, when will they begin graduate study, and area of concen­ tration) . Community Task Force G r o u p — A group made up of key representatives of college alumni, health care agencies and consumers In the SVSC community area. Feasibility Study— A systematic process of analyzing the need, demand and resources for program development and implementation. A needs assessment study. Constituent Groups— Groups that are relevant to the subject of the feasibility. Decision Make r s — People within an organization who have the authority to approve a feasibility study and to make decisions about its use in program planning and resource allocation. Faculty Advisory Groups— A group consisting of SVSC faculty members who will be asked to provide their recommendations for the proposed MSN program (college faculty group and nursing faculty g r o u p ) . 15 Generic Nursing Students--The nursing students who begin Initial nursing education at the baccalaureate program. Health Care Agenclea--Health care agencies Included In the College service area (Appen­ dix A). Key Informants--A representative of each of the constituent groups. Medium-Sixed Hospitals— Hospitals with more than 150 beds and less than 500-bed capacity. Heeda— The discrepancy between what is and what should be or between status and standards. Needs consist of individual n e e d s . as well as. institutional and societal needs. Needs are not necessarily synonymous with demands. Heeda Aaaeaaaent Method— Means used to assess needs, such as a survey, group method, or analysis of social Indicators. Heeda Asseasaent Model--A conceptual framework for a needs assessment* Heeda Aaaeaaor(a)— An Individual or group who are in charge of the needs assessment. Nominal Group Proceaa— A structured meeting which seeks to obtain qualitative information from target groups who are closely associated with a problem area. Potential BSH— A registered nurse with a license to practice nursing in the State of Michigan, currently enrolled in the Bachelors of Nursing Program and intends to complete the degree requirements leading to a bachelor of science degree in nursing. RH Stndenta--The registered nurse enrolled in a baccalaureate nursing program. Small— Slxed Hospitals— Hospitals with less than 150-bed capacity. Social Indicators— Demographic, socioeconomic and health related statistics that provide the data base for program planning. 16 SVSC Service Area— East-Central Health Systems Agency (HS A) Area VI plus Eastern Half of the Area VII. For this study, within 50 mile range from SVSC will apply. 17 ASSPHPTIOHS This study will be based upon the following assump­ tions: A. The program offered by regional col­ leges and/or universities should reflect the needs of the population which they serve. B. A community's needs for educational programs change with other social changes . C. The needs assessment takes place as the beginning steps of program devel-!opment. The findings of the needs assessment are to be used for program planning. LIMITATIOHS OF THE STODT A. B. The findings of this study would only apply to the study area because of the descriptive nature of this study. 1. Because of the sampling techniques of the survey, the number of potential students who are interested In the program would be limited to those who are employed by the health care agencies or to those who are current nursing majors at SVSC. 2. Although the members of the task force groups are to be carefully selected according to the type of agency affiliation and background, the nonsystematic nature of the sampling method would limit the generalizabllity of the findings. The utility of social indicators may be limited by the fact that not all data were current. 19 CHAPTER. XI: THE RETIBV OF THE LITERATURE The review of the literature consists of three major sections. assessment. Identify: The first section reviews the literature on needs The primary objectives of this section are to 1) definitions of need; 2) various models of needs assessment used for this study; assessment; and 4) methods 3) methods for needs for evaluating needs assessment. The second section investigates trends in the U.S. health care system relevant to nursing. This section was Included because these trends will affect the development of a MSN program. The third section reviews the literature on needs assessments relevant for planning graduate programs. 20 I. THE REVIEW OP THK LITERATURE; A. What la a Heed? NEEDS ASSESSMENT The term "need" has been defined differently by the various authors. The clarification of the definition of a need is important because how a need is defined will govern the way the needs are conceptualized and operationalized in the needs assessment process. The review of the literature on the topic of needs assessment revealed the various ways the needs are defined. A need usually is defined in terms of the discrepancy between the actual and desired state of affairs. It can *' also be defined as a set of problems perceived by service receivers, service providers, and their observers. Another, way of defining a need is to differentiate a need of an individual from that of the society. Witkin (1984, p. 6) observes that the term need can be used as either a verb or a noun. The term "need" used as a verb means wants or requirements of a person or group. the term "need" is used as a noun, When it denotes a discrepancy or gap between some desired condition or state of affairs and the actual condition or state of affairs Witkin, 1977). (Kaufman, In the context of needs assessment, 1972; the term "need" is used as a noun and is commonly defined as a "gap between What Is and What (1984) Should Be" (Kaufman, 1982). Witkin similarly defines a need as a gap or discrepancy between status and standards. in terms of two levels: mary-level needs She describes the discrepancy primary and secondary. The pri­ reside in the individuals who are actual or 21 potential receivers of educational, services. or social The secondary-level needs are found in the institution, level, economic, agency or organization. At the individual the needs of students or clients or members of a community are assessed. At the organizational level, the needs of the agency or school system or government body and Its resources, delivery systems and personnel are assessed (Witkin, p. 6). 1984, These levels of discrepancies are further elaborated by Witkin using an educational setting as an example. At the student level, a need is the discrepancy between a desired level of student performance and an actual or perceived level of performance. level, At the institutional a need is the discrepancy between the resources required to meet student needs and the actual resources available. lum, Institutional needs relate to those of curricu­ facilities, equipment, and personnel. The definition of a need in terms of discrepancy can also be applied to human service settings. Kamls (1981, pp. 37-38) defines a need as an identified service need coupled with an absence of a program to meet the need, representing a gap, coupled with insufficient "an umet need” . High need, programs, documented low levels of resources, and/or waiting llstB, indicate that either addi­ tional service or improved efficiency of existing programs are called for. The definition of need as problem is described by Nguyen, Attklsson, and Bottino (1976) as follows: an unmet need Is a condition In which "a problem in living, functional somatic or psychological social process is recognized, a dys­ state, or an undesirable for which a satisfactory solu­ tion requires a major mobilization of additional resources and/or a major reallocation of existing resources." In clarifying ‘the concept of needs for use in an educa­ tional context, Raines (1977, p. 9) found it useful to differentiate between the idlographic view and the nomo­ thetic view. The importance of conceptualizing the ldio- graphic and nomothetic dimensions of any social system had" been stressed by Getzels and Thelen (1972). Extending their concepts into the arena of needs assessment, Raines explains the conceptual framework as illustrated in Figure 1 on the following page. The word idlograph means "written in one's own hand." So the idlographic viewpoint is derived from all that makes us individuals: e.g., tudes, physical nature, our needs, values, attitudes, interactive style. apti­ Therefore, when educational planners assess needs from an idlographic stand­ point, they are seeking to look at the world through the eyes of the individual and then derive educational implica­ tions (p. 9) . The word nomothetic, according to Raines, denotes law- giving or the science of laws, and since laws govern human interaction, one who has a nomothetic view is looking at life through "societal lenses." This perspective is focused on the human and material resources 23 required to maintain society, the structure and function of subsystem, the roles and tasks which must be performed to preserve and enhance the social system. Therefore, the term nomothetic denotes established patterns of implicit and explicit expectations within the society. Because we are affected by both Idio- graphlc and nomothetic dimensions of the social system, the definition of need used in educational planning should Include both of these dimensions. Figure 1. A Conceptnal Framework for Heeds Assessment. ^G»OUS * £01/0 CHUBCH •sc*oot .q «*OFPICIAL»Oo - £ *ST'A*0 SASIC NEEDS ^(?APH'C ^ actional ^oV* '" S fftW C E & S O C '* ° ^^GanizaTIONAL®1 LtJ£s (Adapted from Raines, b e l i e p s . 1977. p. 9) 24 custo B. What Is the Definition and Purpose of a Heeda Assessment? Although the literature varies In the way a needs assessment Is defined, most authors base their defi­ nition on Kaufman's definition of a need as being a gap or discrepancy between what is and what should be in terms of results (1972)* According to Kaufman a needs assessment is: A formal analysis that shows and documents the gaps between current results and desired results (Ideally concerned with gaps in OU T ­ COMES), arranges the gaps (NEEDS) in prior­ ity order, selects the NEEDS to be resolved (Kaufman, 1982, p. 75). He especially emphasizes outcomes the importance of results or rather than the process of whatever program is under assessment. He also explains that needs assessments are tools for constructive and positive change - not change driven solely by controversy, crisis, but rational, "quick-fixes" and situational loglca‘1, functional change which meets the needs of the citizens, educators and learners and English, In summarizing the definition, 1979, p. 8). Kaufman makes important philosophical, as well as, (Kaufman practical points: It (needs assessment) keeps us from running down more blind alleys, from using time, dollars, and people in attempted solutions which do not work. It is a tool for problem identification and justification. It is a humanizing process to help make sure that we are using our time and learner's time in the most effective and efficient manner possible (p. 31). 25 Kimmel as (1977, p. 33) also describes a needs a change oriented process. However, assessment he expands Kaufman's definition of a needs assessment based on discrepancy and claims that Is a needs assessment should attempt to define what required "to Insure that a population Is able to function at an acceptable level in various domains of living"; ... it provides a measure of demand for services "against which the service goals and objectives should be set"; it "identifies the incidence, prevalence and nature of certain conditions within the community"; it assesses the adequacy of existing services and resources (cited in Witkin, Stufflebeam, HcCormic, 1984, p. 14). Brinlterhoff and Nelson (1984, p. 16) defines a needs assessment as: The process of determining the things that are necessary or useful for the fulfillment of a defensible purpose. In more procedural terms, he defines a needs assess­ ment as the process of delineating, obtaining, and applying « information to determine the things that are useful or necessary to serve a defensible purpose (p. 16). Stufflebeam Indicates that a needs assessment can serve two functions. First, it assists in determining what needs exist and how these needs should be addressed. Second, it can provide criteria against which a program's merit can be evaluated, that is, the degree to which intended or impor­ tant human needs are addressed effectively and efficiently. 26 The above three definitions agree that a needs assess­ ment is a logical, systematic and proactive process designed to enhance efficient and effective program planning, mentation and evaluation. imple­ The difference lies in whether or not the definition Incorporates the concept of discrepancy. As there are various definitions of needs, models of needs assessments also vary. Several models are presented in the following section. Models of Heeds Assessment. C. A review of the literature on needs assessment of the past 15 years finds'.' many studies on this topic and a variety of needs assessment models. According to the literature on needs assessment, there is no one model or conceptual framework for a needs assessment that has been universally accepted; moreover, there is little empirical evidence of the superiority of one approach over another (Witkin, p. 53). 1984, p. 29; Kaufman, 1979, The term model is used to describe the framework through which needs assessment is conducted. Each model has been 'developed for a different purpose and for a different s e tting. Kamis (1981, pp. 28-32) describes how a model may use any one or a combination of the following strategies to gather data: 1. Direct needs assessment via survey questionnaire administered on the target population, 27 2. Tapping the opinions and involve­ ment of key informants in the needs assessment process, 3. Inferring needs from patterns of ongoing service utilization, and 4. Inferring needs from known a s s o c i a ­ tions between social area charac­ teristics and the prevalence of social and health problems--social indicators. Among several models of needs assessment literature, (Witkin, two major points have commonly been emphasized 1977). All of the needs assessment models are concerned with goal clarification. models found in the In addition, most of the Involve constituents in varying degrees in the needs' assessment process. In educational needs assessments constituents are educators, educational product. the students and consumers of the Witkin (1984, p. 31) describes the constituents as a three-way partnership among service providers, service receivers, and "stake holders". Among several major models found in the literature, « three that are relevant to needs assessment education are examined here. College Model, in higher They include: the Community the Multicomponent Training Model, and the Transactional Model. A Community College Model developed by 7uc^ er (cited in Witkin, 1984, p. 47) focuses on the relationship of commun­ ity college curricula to community educational needs. model is based on the definition of need, crepenacy between what not as the dis- is and what should be, 28 The but rather the gap between what Is and what could be. Tucker explains the reason for use of what could be as: Since the set of educational offerings identified as needed In the future will always be baaed on some data derived from the present, and since there are .many forces acting on the shape of the future, the set of needs Identified must represent alternatives for the future direction rather than what Ideally should be. In this model, occupational needs for the service areas of the community colleges are assessed and then matched with curricular offerings. The model calls for a major discrep­ ancy analysis between baseline data on community educational needs, present skill needs, social/cultural needs, special community Interests and priority of educational needs (Wltkln, 1984, p. 48). of why they differ, The analysis addresses the question where and how much they differ, can be done to change things (Wltkln, 1984, and what p. 48). The Community College Model Is an example of how to match the educational needs of students and requirements and opportunities in the external world. This Is an important area to consider in a needs assessment conducted by regional universities or colleges, which primarily serve the sur­ rounding community. A Multicomponent Training Model developed by Mlsanchuk (1982) is an approach for assessing training needs In the business sector. model are: Two major questions addressed in this What do people do, and what do they value doing? 29 Three components of needs Important in this model are: relevance of the task for the job r o l e f competence of the employee in performing a task or skill, and desire of the employee to undertake education or training. Need can be defined in terms of one to three of these components, depending on the situation. The survey instruments are constructed accordingly with self-reports about relevance and competence in one part and the training component in another. Because the model takes into account various components of need, it is known to focus on usefulness of knowledge rather than mere preference of the employee (Witkin, 1984, p. 45). The last model presented here is a Transactional Model. It was described by Raines (1974 and 1977) and its applica­ tion was reported by Costick: (1975). The model was based on the definition of needs as having two dimensions: graphic (personal) and nomothetic (societal). idlo­ Consequently a comprehensive needs assessment in educational programming must address both Individual and societal requirements. In order to determine individual learning needs accurately, process." Raines introduced He uses the approach: "The needing the term "needing process" to denote the complex Interaction of many factors that determine the type of educational experiences required. person's feelings, values, They include: the beliefs and experiencces. Interaction of these aspects create "tension states” within 30 an individual, launching the "needing process." Raines describes four states of the "needing process" as follows: 1) need differentiation, simulations, 2) goal visualization, 3) reality and 4) agenda formulation. In this model, the constituent group approach is recommended to facilitate the "needing process." Represen­ tatives of the constituent group share their concerns, identifying their needs, accomplish each goal. and set goals and strategies to This model'is termed as a "trans- active" because it encourages the involvement and inter­ action of the group members in the process. approach, Through this commonalities of the needs of the constituent group are identified and individual differences are acknowledged. Through the "needing process" a variety of learning needs will be identified. Raines lists the following as possible learning needs for adults: 1. 2. 3. 4. 5. 6* Personal development needs, Career development needs, Family life needs, Civic development needs, Cultural development needs, and Recreational development needs. Some of these needs can be met through non-formal educational programs, programs. while others Having determined require formal academic the idlographic needs, another important aspect of transactional approach is to assess nomothetic expectations and requirements. the Because each individual is a member of the organization or the society, 31 his or her learning needs are affected by organizational and societal expectations* and requirements To assess nomothetic expectations is to learn what the organization, agency or community desires in terms of resources, and commitments (Raines, 1977, p. 31). or structure Those within the organizations and agencies are in a position to provide significant bents, information about their needs as role incum­ the training needs of others in the organization, needs of their clients or customers, the and the needs of their organization from an operational point of view. However, it is important to keep in mind the differences between the views of the individual and those of the organization. assessing needs, be balanced the idlographic and nomothetic needs must (Ibid, p. 32). In order to facilitate cation, D. The following sec­ the various methods of need identification. Heeds Assessment Methods. methods, * the process of need identifi­ a variety of methods are used. tions discuss In Group processes, survey and social indicators are three primary needs assessment methods found in the literature (Wltkln, 1984). Although the survey method has been used most frequently (Roth, 1978), the use of input from the constituent groups and analysis of social indicators both have become a common practice in needs assessment today. Each of-these methods is used in combination with another of more than one method probably leads to more accurate assessment of needs. 32 or by Itself. The use THE GROUP METHOD Group processes provide a qualitative method to supplement quantitative means of needs Identification and problem analysis (Wltkln, 1984, p. 129). Another critical dimension of the group process is that it Involves service receivers, service providers and "stake holders" In the needing process. This sets the stage for the subsequent Involvement of all constituent groups In program develop­ ment. For the purpose of identifying needs, the group process approaches usually employ "key informants" who represent segments of the constiuency. to a manageable size: The group is kept no more than 15 members. Several types of group processes used in needs assess­ ment are found in the literature. the Hominal Group Process Among these, the use of (NGP) is most frequently cited. This method was developed by Van de Ven and Delbecq (1972). They defined it as a "structured meeting which seeks to provide an orderly procedure for obtaining qualitative information from target groups who are most closely associi ated with a problem area" (1972, p. 338). The following advantages are known to be associated with the use of the Nominal Group Process according to Van de Ven and Delbecq (1972, 1975). 1. NGP allows target groups to single out critical problems In a non-threatening setting. 33 2. It seeks contributions from all the participants before it asks each member to rank the various proposals. 3. It deliberately sets up (through the silent brainstorming period) a dynamic tension which is seen by the authors as fostering creative thinking. 4. It eliminates semantic barriers by providing for communication and clarification of ideas before the aptness of the ideas is ju d g e d . 5. It provides a structure which can control those who would seek to dominate the discussion. 6. It permits a rational by group participants subject and objective the problem (Raines, and 38). examination' of both aspects of 1977, p. 36 Van de Ven and Delbecq advocate careful selection of target group members. The participants must be homogeneous enough to be able to agree oil some priorities. tions posed to the group must be perceived pants i as clear, The ques­ by the partici­ relevant and worthy of their time. The research conducted by the orginators of NGP found this method useful, but Green (cited in Raines, through his research, types of needs. p. 38) did not support the above finding. In spite of conflicting merit of this model, 1977, research data regarding the it is widely applied to assess various Its advantages are that it is not suited for the diverse group members, group size. 34 but it is suited to a small THE SURVEY METHOD The second method used for conducting needs assess­ ments Is the survey method. "survey" generally refers preferences, In needs assessment, the word to the gathering of opinions, and perceptions of fact by means of written questionnaires or Interviews (Witkln, 1984, p* 63). Roth (1978) in her review of the needs assessment literature of the past decade found that it was the most frequently used method found in needs assessment literature. In compre­ hensive studies it is often combined with other data collection methods such as social Indicators and group processes (Witkin, Raines (1977, 1984, p. 63). p. 43) suggests that a community or constituency survey is best undertaken after a transac­ tional assessment has been made, because neither paperpencll survey nor interview survey is effective In diag­ nosing or simulating the actual needing process of constituents. However, surveys are very useful in verifying the extent to which previously diagnosed needs « exist within the constituency. Witkln raises the following points as Important areas to consider when the survey method is used for needs a ssessment: 1. There should be a theoretical frame­ work - a specific needs assessment mode 1. 35 2. A survey can gather opinions about the two major elements of needs assessment: status and standards what is and what should' be (in terms of results). 3. Both the wording of survey item and the instructions to respondents are all- Important in clarifying the distinctions between wants and needs. 4. If the survey is not the sole source of data, the needs assessor must decide when it should be used. Various types of surveys are described in the litera­ ture. The community survey methods can be classified according to the target group such as an omnibus or targeted survey. In the former, cltizens-at-large is studied; the random sample of in the latter, a particular group or constituency within the service area is studied. Another way of classifying survey methods is according to how the data are collected such as through question­ naires or interviews. The questionnaires can be adminis­ tered in groups or individually, under the direction of the researcher or by the subjects themselves. The question- % nalres can be hand-delivered, telephone. mailed in or administered by The choice of methods of distributing and administering written questionnaires is important in order to assure the highest rate of return consistent with time and budget constraints (Witkin, wide citizen surveys usually mailed, cent. 1984, p. 93). Community- for human service needs assessment are with a return rate of from 30' to 60 per­ The return rate can be increased by a variety of me thods. 36 SOCIAL INDICATORS Social Indicators are demographic and statistical data that Identify the size and characteristics of population groups with particular needs, the symptoms of those needs, and the scope of a problem (Witkin, 1984, p. 100). Social indicators are useful when they are combined with data obtained through other methods. with goals or standards, Witkln states When they are combined they can show evidence of needs. that social Indicators are most useful as inputs to the "what is" or status component of the needs assessment, whereas surveys are most useful for establish­ ing the "what should be" or standards component. The indicators can usually be obtained from various sources which routinely collect data. Local government units such as city and county planning departments, state and local health departments, and health systems agencies can provide local social and health indicators. and Budget, Nationally, the Office of Management the National Center for Health Statistics, the Mental Health Demographic Profile Systems and (DPS) of the National Institute of Mental Health are sources useful for needs assessment. R o 8s1 and Gilmatln (cited in Witkln, 1984, p. 112) describe the merit of the use of the social Indicators as follows: "Use of social indicators permit conditional forecasts of key indicators. Such forecasts can serve the needs of educational planners and practitioners in that 37 they allow for actions to be taken before the problems become severe." On the other hand, social Indicators must be used with caution in needs assessment because of potential unreli­ ability and obsolescence of the data. When using social Indicators to study trends it is important to know whether there have been Interventions that have affected a time series. There may be abrupt, delayed, or temporary changes in level or direction of indicator values occurred because of some interventions 126). that have (Witkln, 1984, p. This situation can be Illustrated by the recent trends in health care in the U.S. Many of 1980 census data may be used to project trends in health care, such as the hospital utilization rates and health manpower needs. the other hand, the recent governmental interventions the U.S. health care system have caused many changes, making many aspects of 1980 census data obsolete. On in thus Efforts should be made to obtain the most current and reliable data for use as social Indicators. 38 EVALUATION OF HEEDS ASSESSMENT In order to insure Che quality of needs assessment, it should be judged against appropriate and generally agreed upon standards* A national committee called the Joint Com­ mittee on Standards for Educational Evaluations (1981) has identified and defined 30 standards for use in assessing evaluation of educational programs, projects, rials. The standards are grouped according to four attri­ butes of a study - utility, accuracy. In presenting feasibility, the standards, has been substituted for "evaluation" 1985, and m a t e ­ p. and "needs assessment" (Stufflebeam, et al., 181). The utility standards acquaint propriety, require investigators themselves with their audiences, audience's questions, to obtain relevant report it clearly and in a timely manner, audiences use it. to to ascertain the Information, to and to help the The feasibility standards require that the study is operable in a setting .which it is to be applied and that no more materials and personnel t consumed than necessary. time be The propriety standards aim to insure that the rights of persons affected by a study will be protected. The accuracy standards require that the obtained Information be technically adequate and that con­ clusions are derived logically The standards needs assessments, from the data. provide conceptual tools but procedural These include evaluating the plan, 39 for evaluating plans are also needed* the process and the out- come. The evaluation of the needs assessment adequacy of the design and plans for implementation. evaluation of the process assesses how well assessment Is being implemented. outcome addresses the question: the needs assessment. The the needs The evaluation of the How good and valuable was Sample evaluation questions and checklists are also available Sanders and Nafzlger, plan Include 1975). V 40 (Stufflebeam, 1985, p. 197; II. REVIEW QP THE LITERATUREt THE TRKHDS IH THE P.S HEALTH CARE STSTBH THAT WOULD AFFECT HURSIHC— IHPLICATIOHS IH THE PBVBLOPMEHT OF A MSH PROGRAM The health care systems In the United States have been experiencing dramatic changes In various facets of their operation during the past several years. Andreoll and tiusser (1985) list several major health care trends that would have great Impact on the field of nursing In the future. These trends Include: 1. 2. 3. 4. The "Graying of America", Escalating health care costs, Technology on the rise, and Health promotion and self-care. In order for an academic nursing program to grow and/or survive, It must take each of these trends Into account In Its short- and long-range planning. The "Graying of America" will have a significant influence on the delivery of health care and on the roles of nursing in coming years. Currently Americans age 65 and older make up over 10.5 percent of the overall population (Whitfe House Conference on Aging, 1981, p. 33). It is anticipated that this percentage will nearly double by the year 2030 (Andreoll and Musser, 1985, p. 47). Because people suffer more chronic illnesses In their later years, the increase of the older population means that there will be a corresponding increase in the number of people who live with one or more chronic Illnesses, thus requiring substantially more health care services than younger population groups (Health Resource Administration, 41 1981). Utilization of health care services by this age group are particularly high in the area of acute and long-term care, office and pharmacy services. The elderly now use more than one-half of all acute hospital bed days (National Center for Health Statistics, 1979). health care services Increases, Moreover, as use of there is a corresponding decrease in income level--an important interaction between a socioeconomic problem and health status. The poverty and Increased numbers of chronic illness that are observed in the elderly population Indicate that, individual attention is needed. In order to assist the elderly population to cope with complex health problems, specialized knowledge and skills will be required of an Increasing number of professional nurses. Such specialized background in nursing could best be acquired in a master's level study. Thus gerontological clinical nurse specialist program have been created by a number of graduate nursing programs across the United States in the past several years. ■ Escalating health care costs in the U.S. have pro­ foundly influenced the health care systems in the past several years. The exponential increase in the health care costs during the past decade has been addressed by the government through changes in the method of reimbursement to providers of care for medicare and medicaid subscribers. The reduced income primarily caused by the prospective reimbursement method for medicare and medicaid subscribers 42 demands that health care agencies be much more efficient and Innovative In their operations.. In order for them to survive the competition. ment method, Under the prospective reimburse­ the length of stay for hospital clients has been shortened dramatically, and they are more often discharged with treatments and care still needed at home. Also, the average hospital client Is much more acute. As the health care system strives ness and managerial efficiency, for cost effective­ a professional nurse must contribute to achieving these savings while at the same time maintaining the quality of health care services. Although basic leadership skills and knowledge of health care economics should be a part of the baccalaureate nursing curriculum, skills much more specialized knowledge and In leadership and fiscal management are demanded from today's nurse executives. The professional nurse with such responsibilities would best be prepared in a graduate nursing program where theories of nursing are combined with leadership, management and economic curriculum components. t The implementation of prospective reimbursement medicare and medicaid subscribers for in the area hospitals has also resulted in an increased need for home health care. Consequently many proprietary home health agencies have come into existence In the past several years. many predictions being made about care agencies, In spite of the growth of home health the quality of services is seldom controlled nor do these agencies have enough competent nursing 43 leadership. A professional nurse prepared at the graduate level would provide much needed leadership in hone care nursing and would affect the quality of health care provided at these settings. Health promotion and self-care have been the topics of great emphasis among the consumers in the recent years. Naisbltt (1982, p. 134) writes: The new emphasis on the human angle shows up in three major trends behind the move from institutional help (the medical establishment) to self-help (personal responsibility for health): 1. New habitB that actualize new-found responsibility for health; 2. Self-care that illustrates our selfreliance in areas not genuinely requiring professional help; and 3. The triumph of the new paradigm of wellness, preventive medicine and holistic care over the old model of illness, drugs, surgery and treat­ ing symptoms r&ther than the whole person. Traditionally nursing's armamentarium has included helping consumers take responsibility for their own health (Andreoll and Musser, 1983, p. 87). Today the role of a professional nurse in consumer health education has been accentuated as consumers attempt to become more selfreliant in their own health. In particular, at-home health promotion and education programs will flourish among the burgeoning elderly population (Andreoll and Musser, p. 49). 1985, It is assumed that an MSN-prepared nurse with a 44 background In community health, home health .care and gerontology would be able to play a leadership role In developing sound health education programs. Advanced biomedical technology and computerization of health care already have had a great impact on the delivery of nursing care. The shortened lengths of stay caused by the implementation of the prospective reimbursement methods have led* indirectly to increasing acuity levels of hos­ pitalized persons. The famous quote by the leaders of health care systems: "hospitals will soon be huge inten­ sive care units in the near future" would become a reality in the near future 1985). (Levine, E., 1980, pp. 18-19; Brown, B . , Professional nurses will be required to have advanced knowledge and skills in highly specialized and technologically advanced health care. Currently the costs of inservice programs provided to the nurses in the "high tech" area to keep abreast of ever changing technology are phenomenal— costs which must come directly from the charge to the clients. Musser Andreoll and (1985, p. 49) write that expanded technology will continue to require more technological skills among nurses, leading to expanded nursing roles. The graduate nursing program would be an appropriate setting for learning such an expanded nursing role. An adoption of "high tech” in the health care system has brought on another challenge to nursing practice. Naisbitt (1983, p. 39) writes: 45 What happens is that whenever new tech­ nology is introduced into society, there must be a counter-balancing human response - that is high touch - or the technology is rejected. The more high tech, the more high touch. With an advancement of "high tech" in health care delivery system, humanistic and ethical considerations have become critical issues among all health care professionals. Professional nurses often face situations where ethical decisions must be made. A professional nurse who is prepared at a master's level would be better able to play-' a leadership role in dealing with these dilemmas faced by health care professionals. 46 III. HKBDS ASSESSMENT LITERATURE RELEVANT FOR PLAHHIHG GRADUATE PROGRAMS A needB assessment Is an essential step in planning a graduate program. Selected literature relevant to planning graduate programs is described in this section. HEEDS ASSESSMENT IH PLAHHIHG A GRADPATK PROGRAM In planning a new off-campus graduate degree program leading to the Master of Arts in Liberal Studies, Bock (1980) conducted a needs assessment at the University of Illinois at Urbana-Champaign. The three central Issues addressed in the study Included: 1. Has a new degree for adults suffi­ cient priority within the mission of the university? 2. Here there sufficient client and faculty interest and support for the program? 3. How should the program be structured to satisfy both the requirements of the institution and the needs and wants of faculty and clientele? Tn order to deal with these questions a small commit­ tee was formed, ments. consisting of staff from relevant depart­ The study used three Information gathering tech­ niques, including telephone surveys, spective clientele, committee. Interviews with pro­ and formation of a citizen's advisory The strength of this approach was that the faculty members and administrators who planned the program, had an opportunity to study the idea thoroughly and con­ tribute to the program. The study also provided 47 information as to what important to them. the prospective clientele felt was The weakness of the study was that the overly "thorough" design of this study took three years to complete. 48 CONDUCTING A. FEASIBILITY STUDY FOR A H A S T E N S DEGREE PROGRAM IM HORSIMG Developing a master's degree program in nursing is a complex process requiring much advanced planning (Epstein, 1978, p. 1). There are certain preparatory steps in the process of master's program development, first of which is the feasibility study regarding needs and resources: human, physical and financial. Epstein suggests that the data collected in the feasi­ bility study is crucial for the effective planning and implementation of the master's program. This encompasses the following: External R es o ur ce s: 1. Needs and demands of students, com­ munity agencies, consumers, and state or regional planning groups (includ­ ing the legislature). 2. Availability of clinical resources adequate to graduate-level experi­ ences -(Including acceptance of philo­ sophy, accessibility,, and role models). 3. A pool of available faculty prepared to teach at the master's level. Internal R e so u r c e s : 1. Human resources (e.g., faculty, support for the programs, supportive cognates and other graduate offerings, compati­ bility of philosophy, policies and practices of the university, graduate school, and the school of nursing). 2. Adequate finances planned over a fiveyear period to Include faculty, support personnel, library funds, equipment, travel, consultation and supplies. 49 3. Facilities that are adequate In number, size, location, and flexibility to pro­ vide for present and ongoing program needs. These data need to be collected during the feasibility study to be utilized in decision-making and planning for the proposed program* Epstein's list of items is a valuable source upon which a comprehensive feasibility study can be based. In order to review the literature of feasibility studies in planning a masters degree program in nursing, several funded grant proposals were reviewed at the Depart­ ment of Health and Human Services. were The proposals reviewed all from outside metropolitan areas in various states, and resembled the surroundings of SVSC. Each proposal Included a feasibility study, although the design and the scope of these studies were different. The feasibility studies in planning graduate nursing programs from New Hampshire, Washington, Minnesota, and Michigan were reviewed, North Dakota, three of which are * presented below. The study conducted by one college In rural Minnesota consisted of the survey of registered nurses in 21 northern Minnesota counties (Freeman, 198S). Because a sampling frame of baccalaureate prepared RNs was not available the questionnaires were sent to all registered nurses in that region. (N-4,478) A return rate of 29Z was attained. 1,316 respondents, Of the 668 indicated interest in participating SO in the MSN program. Among those, 440 were eligible as applicants o£ the proposed program. In order to determine job demand for Minnesota masterprepared nurses, questionnaires were mailed to 12 schools of nursing and 34 hospitals. Health care facilities other than hospitals were not surveyed. The study also Included the assessment of the degree of commitment and support in the college as well as availability of clinical facilities in the area. A private grant of approximately $6,000 was allocated to conduct this study. The study in North Dakota consisted of a total of 2,821 questionnaires mailed to the registered nurses over two states (Zlnsel, Holly and Carl, 1979). Again diffi­ culty was encountered in identifying a readily obtainable sampling frame of the baccalaureate of the states. prepared nurses in one Among 1,639 eligible persons surveyed, 1,034 persons responded with a response rate of 63.1%. The second part of this study involved the examination of the Job market for graduates of a masters degree program in * nursing. Several types of health care agencies were sur­ veyed to determine potential employment opportunities and needs for masters prepared nurses. The structured inter­ views of the directors of nursing were conducted at 37 health care agencies sampled. The study was conducted by three nurses with a Ph.D. under a private grant of $12,500. 51 The third feasibility study in nursing presented here was conducted by Northern Michigan University in 1962 (Olson, 1982). The study consisted of the surveying of registered nurses in 15 counties of the Upper Peninsula. This study was an update from the previous study conducted in 1978. A total of 130 questionnaires were mailed with 54Z being returned. The survey was conducted to determine the interest/need in the Upper Peninsula and surrounding region for a Master of Science in Nursing Program, with a major in nursing service administration and a minor in adult health. A non-probability (non-randoraly selected) sample of registered nurses who had earned BSNs was sur­ veyed. Subjects were obtained from graduate listings of the University"s School of Nursing as well as from BSN nurses who filled in questionnaires passed out at health care settings. were Interested, The survey identifies 50 respondents who of whom 35 stated they were ready to begin the program as soon as possible. Many of the respondents made comments that they would be Interested more in parttime, weekend workshop-type classes because of their current employment situation. respondents had The majority (77Z) of the received their BSNs within the previous 5-7 years. The review of the feasibility studies conducted for planning a masters degree in nursing revealed that many studies were of large scale, the RNs in the region, sending questionnaires thus a costly endeavor. 52 to all Some had special project staff. The last study presented above did locate the BSNs as respondents, however, it was a non- probability sample. These studies primarily focused on the surveys of the poteutial students and the potential employers. None of the nursing studies described above used the group method as an alternative to or a supplemental data collection method for a feasibility study. 53 SUMMARY The review of the literature covered three topics needs assessment, the trends of U.S. health care system relevant to nursing, and the needs assessment in nursing. The definition of a need was clarified, and three models of needs assessment relevant to this study were reviewed. survey, group, The and social Indicator methods were discussed as approaches that can be used alone or in combination. A conceptual framework for evaluating the needs assessments ■were then presented. The literature which describe the U.S. health care trends as they related to the development of a MSN program also were reviewed. The last part of the review of the literature dealt with the needs assessment conducted in planning graduate programs 54 including nursing. CHAPTER III: METHODOLOGY This chapter provides a description of the design, methods and procedures used to conduct the feasibility study, as well as to evaluate the process and outcome of the study. The model applied for this study was based on the combination of the three needs assessment models presented in the previous chapter. needs assessment 31; Raines, 1974) (Kamls, The review of the literature on 1981, pp. 28-32; Witkln, 1984, p. revealed that a "comprehensive" needs assessment addresses needs and resources of all constituent groups. If one intends to develop a successful educational program, needs and resources must be assessed at both indi­ vidual and organizational levels. An educational program which bases Its focus primarily on the learner's interest or preference but Ignores the needs and resources at the organizational level may be appealing on the surface to the learners, but it will fall short of long-lasting success because such programs may run into difficulties securing funds or its graduates having difficulty securing employment using their newly acquired educational backgrounds. three models described above take into account, needs and resources both at the individual and organizational tutional and societal) levels. The (insti­ Although the use of termin­ ologies in defining the constituent groups are different, all the models, involve various types of constituents 55 in the needs assessment process. In any type of setting! the con­ stituents of the needs assessment would consist of service providers, service receivers and "stakeholders'*. educational setting, In the the service providers are faculty mem­ bers and administrators of the educational program. receivers are potential students. Service Stakeholders are con­ sumers, employers and legislators who would have direct or indirect Influence on the educational process or product. The aforementioned models utilize three primary means to collect data: methods. group, survey and social indicator The group method, which key Informants from vari­ ous subgroups of the constituents meet together to define needs, resources and concerns, is one of the most popular methods used to collect qualitative data. The review of the various social indicators is the second method that supple­ ments or substantiates method. the data obtained through the group The third method is the survey. most popular, Although it is the it should be used in conjunction with the other two methods. Raines (1974) explains that the survey method used above is not effective in diagnosing the needs because it lacks transactions between the need assessor and those whose needs are being assessed. useful method However, it is an to validate the types of needs Identified through the other two methods. The needs assessment model used for this feasibility study is a combination of all three models described above. 56 In order for Che study to be comprehensive, representa­ tives from all constituent groups were Included in the study. This study used a combination of the task force groups, survey, and social Indicator methods in order to obtain the answers for the research questions. In order to assess the appropriateness and efficiency of the approaches used to conduct this study, both formative and summative evaluation have been conducted based on the standards developed by the Joint Committee of Standards for Educational Evaluation (1981). Figure 2 Illustrates the process followed for conduct­ ing this study. The chapter is divided into the following major sections: setting, needs assessment methods, cedures, evaluation methods, 57 and summary. pro­ Figure 2. The Process of Heeds Assessment In This Study* Step 1: Task Force Groups: A. B. C. D. Community Representatives Alumni, Nsg Program (SVSC) Nursing Faculty (SVSC) College-wide Faculty (SVSC) / 1 / Evaluation \ I of the j ---\ Process j Ln 00 ^ Identified Needs and Resources v (Qualitative Data) Step 3: Step 4: Review of Social Indicators to Supple­ ment/Validate the Information Gained in Step 1 Judgement of Feasi­ bility Through Inter­ pretation of Qualita­ tive and Quantitative Data I 1 I 1 Step 2: Evaluation' \ Surveys: A. B. Potential MSN Students 1. RNs 2. Current nursing students Potential Employers of HSNs Identified Needs and Resources _ (Quantitative Data) SETTING The study was conducted at Saginaw Valley State Col­ lege University Center, Michigan. The college is surrounded by three cities within a 30 mile radius. These cities Include Bay C i t y f Midland, and Saginaw with respective pop­ ulation of 41,593, and 77,508 at the time of the 1980 census. 37,250, The college also serves the surrounding 14 county area which is primarily agricultural. The City of Flint with its population of 159,611 is located approxi­ mately 45 miles southeast of the college (Figure 3). The area within a 50 mile radius from the college was iden­ tified as the study area. Saginaw Valley State College currently offers a bacca­ laureate degree in nursing both for generic and registered nurse candidates. Delta College located within four miles from SVSC offers an associate degree in nursing. miles from SVSC, Within 50 three other' associate degree nursing programs and one upper division baccalaureate nursing program exist. The location of these programs to SVSC is shown in Figure 3. offers a MSN degree in relation The nearest university which is located 70 miles southwest of SVSC, at Michigan State University. Other MSN programs are offered at the University of Michigan, and Wayne State University, Oakland University but these universities are located over 80-120 miles away from SVSC (Figure 4). 59 Figure 3. SVSC and Surrounding 30 Nile and 50 Mile Area. <1rtland Community College Harrlspn **' Standish Mld-Htchlj*n Community Col lege C af.soct :ity C o im u nlty C o l le g e St. Johns U n i v e r s i t y of M ichigan, F l i n t 60 Figure 4. Distance Between SVSC and Surrounding BSN and HSN Programs. Northern M v W Unlverslt; Ferris State College • Michigan State University Andrews University Un1ver1sty of Michigan Oaklaffir University ^ M S a o n n a College Wayne State Jbnlverslty • >i» Q Masters In Nursing Progran Baccalaureate Programs in Nursing A variety of health care agencies surrounds SVSC. type and number of these agencies are listed In Table Wit h in 50 miles care hospitals 1. from SVSC there are 13 medium sized acute (bed capacity over 150). agencies provide all surgery, The types of services burn and oncology services. has 24 small hospitals These health care including open-heart The same area also (bed capacity under 150). Public health de partments/visiting nurse associations number 11 within this 50 mile circle from SVSC. agencies, Some 13 home care 31 nursing homes/l on g -t er m care facilities, and four schools of nursing are also within this 50 mile para­ meter. 62 TABLE 1. NUMBER OF HEALTH CARE AGENCIES LISTED BT THE MICHIGAN DEPARTMENT OF PUBLIC HEALTH (MDPH) AND SCHOOLS OF NURSING WITHIN 30 MILES AND GREATER THAN 30 TO 50 MILES OF SAGINAW VALLET STATE COLLEGE JANUARY, 1985. Number of Agencies Within Distance from SVSC Major Types of Health Care Agencies Within 30 Miles Greater Than 30 to 50 Mile s N N Medium size hospitals (bed capacity over 150) 7 6 Small size hospitals (bed capacity under 150) 3 21 Public health depart­ ments/visiting nurse associations 5 6 Home care agencies 3 10 13 18 1 3 Nursing homes/long-term care facilities* Schools of nursing** *0nly those accredited by medicare and medicaid were • taken into account. **Not listed by MDPH. 63 POPULATION The population for this study Included the various constituent groups that are relevant to the development of a MSN program. students, The constituent groups included potential employers, community representatives and college p e r so nn el • 64 HEEDS ASSESSMENT METHODS This study used the task force group, the social indicator methods the survey, and to identify the needs and resources for the proposed MSN program. These following three subsections will describe in detail the populations, sampling techniques, A. and procedures for each. The Task Force Group Method Neither the paper and pencil survey nor the structured interview provided opportunities for respondents to inter­ act with other respondents while completing the question­ naire or Interview (Raines, 1977, p. 35). The task force approach with a representative group of constituents allowed interaction among the members of the groups, and provided opportunities for b o t h .respondents and researchers to clarify issues at hand. Consequently, the Information collected through this approach tended to yield qualitative data. It was also suggested that this approach could be desirable in building a survey instrument for later use with a larger sample. The Task Porce Group Method (Witkln, Raines, 1977, 1984, p. 129; p. 35) was used to Identify the needs and resources for the proposed MSN program from the perspective of each constituent group. were formed: wide faculty, a community, Four main task force groups a nursing faculty, and a nursing alumni group. 65 a college- The Nominal Group Process was used to conduct alL task force meetings to economize time and maximize the produc­ tivity of the sessions. Ven and Delbecq (1972, This method, p. 338), developed by Van de is a structured meeting which seeks to provide ah orderly procedure for obtaining qualitative information from target groups who are most closely associated with a problem area. Figure 5 presents a schema of the Nominal Group Process (Raines, 37) . 66 1977, p. Figure 5. A Schema of the Nominal Croup Process. Focus Generating Ideas Priority Setting Steps Procedures Time Silent Brainstorming Members write their Indivi­ dual responses to the challenge question 15 min. Idea Record-* Ing Round-Robln listing of responses on flip charts without comment 20 min. Idea Clarifi­ cation Clarification and coordina­ tion of Responses without value judgment 20 min. COFFEE BREAK 10 min. Ranking Ideas Members use 3 x 5 cards to rank the ten most important Ideas individually 15 m i n . Recording Group Judgments Members post their rankings by their preferred items on flip chart 10 min. Discussion Group discusses and defends relative merits of various responses to the question 30 min. Scoring Period Members Individually score top ten items on 10 point scale and turn in scores 10 min. (Modified from Raines, 1977) 67 The primary question to be answered by the task force groups was one of the primary research questions: Are there substantial needs and resources for the development of a Graduate Nursing Program at SVSC? Each group, then addressed two questions related to the main question. Table 2 lists the questions addressed by each task force group. 68 TABLE 2. QUESTIONS ADDRESSED BY EACH TASK FORCE GROUP. Groups Questions Addressed Community Task Force Session 1 1. What needs exist in the area for MSN prepared nurses? 2. What resources are available in your agency or setting? 1. What may be the potential bar­ riers to the development of the proposed MSN program? 2. What types of planning would be necessary in order to plan successful MSN program? Session 1 1. What academic considerations should be addressed related to the development of a graduate Nursing Program at SVSC? Session 2 2. What administrative and finan­ cial plans do you think we should address? 1. What kinds of academic concerns do you feel should be addressed upon the development of a Grad­ uate Nursing Program at SVSC? 2. What administrative and finan­ cial concerns do you feel should be addressed? 1. What would motivate you to enroll in a MSN program if developed at SVSC? 2. What would be barriers for you to enroll in a MSN program if developed at SVSC? Session 2 Nursing Faculty Task Fo rce College-Wide Faculty Task Force SVSC Nursing Alumni Task Force 69 The Nominal Group Process began by the group leader introducing the two major questions to be addressed by each group. Each member then silently brainstormed and wrote down concerns and ideas related to the program. Each then took a turn listing an idea or concern on the board. The items were then ranked according to their perceived impor­ tance. All the group sessions were tape recorded for the later review. Explanations for each of the task force groups follows. 1. The Community Task Force G r o u p . The purpose for constituting this group was to obtain their opinions and input relative to the needs assessment. These key commun­ ity representatives within the organizations and agencies were in a position to provide significant information about their needs as role incumbents, others in the organization, customers, the training needs of the needs of their clients or and the needs of their organization from an operational point of view. The task force group approach « permitted members of the group to Interact and clarify ideas (Raines. 1977. p. 35). The members of the Community Group were selected from each of the constituent groups. Non-probability, sampling was used for choosing members. purposive The constituent groups were identified as potential student population, consumer group, potential employers of the different 70 types of health care agencies, local medical association, trict nurses' association, dis­ health systems agency and the faculty of existing master's degree programs at SVSC. A director or a representative from each of the constituent groups was asked to participate In the task force. The following Is a list of the membership of the Community Task Force Group. 1. Directors of nursing from three major hospitals In tri-county area, 2. A director of nursing from the Visiting Nurses Association (VNA), 3. A director of nursing from a county health department, 4. A director of nursing from a nursing home , 5. A director of nursing from a home health care agency, 6. A reperesentatlve of the regional Health Systems Agency (H S A ) , 7. A physician representative from the local medical association, 8. A representative of the District Nurses' Association, 9. Representatives of the existing master's degree faculty members at SVSC: a. b. c. Master of Arts in Teaching, Master of Arts in Criminal Justice and Political Science, and Master of Business Administration (MB A) . 10. A consumer representative, 11. A representative of the nursing alumni group. 71 and The designated members of the Community Group were contacted by phone or In person by either the Dean of the School of Nursing or by the researcher to request participation. A follow-up letter formalized the appoint­ ment and reminded the' members about the meetings Appendix A). their (see Those who were unable to attend a meeting were asked to send an alternate. The Community Group met twice, approximately one month apart in December, took two hours. 1985 and January, 1986. Each meeting A comfortable meeting room In the new administration building on campus was used and refreshments were provided. The first session was used to elicit opinions, con­ cerns and Issues related to the development of a MSN pro­ gram. At the beginning of the meeting, of the proposed program was presented. a brief description This presentation was to provide the members with a reference point and was not intended to be the final form of the program. The discussion focused on the identification of needs and reso ur ce s. By the end of the first meeting, the group had p r i - . orltized six major issues to be addressed in the second meeting. The members used the time between the two meetings to study and reflect on the issues encountered in the first meeting. The proceedings of the meetings were tape recorded and later carefully analyzed in order to answer the research 72 questions related to potential employers and the college representatives. These issues, concerns and opinions raised were used to design the survey questionnaires* 2. Nursing Faculty Task Force G r ou p. All members of the Department of Nursing were asked for their input into the development of the MSN program. A two hour meeting was held twice for this purpose (January IS and February 1986). 12, A letter Informing the faculty about the date, time and agenda was distributed to each member prior to the meetings (Appendix B). At the end of the second meeting, the faculty provided the researcher with a number of ideas and concerns regarding the proposed program. The recommen­ dations of the Nursing Faculty Group were used to answer a set of research questions presented previously. 3. College-Wide Faculty Task Force G r o u p . faculty members, Twelve each of them representing his/her depart­ ment at SVSC, were asked to attend a two hour meeting for the proposed MSN program. 1986 for two hours. The group met on January 23, Because of the conflict with their » teaching assignments seven faculty members were able to attend. At the end of two hours, the group had identified a number of valuable opinions and ideas. 4. SVSC Nursing Alumni Task Force C r o u p . representatives Several from the Alumni Association of the School of Nursing were asked to attend this group meeting. Seven SVSC alumni on this task force were employed by area hospitals and home care agencies attended the meeting on 73 January 28, 1986. The two hour meeting was conducted using the Nominal Group Process. The members of this group expressed much Interest toward the proposed MSN program. The type of program and the areas of concentration desired were the major Interests expressed by this group. The input from each of the Task Force Groups was Identified and used for the refinement and the development of the survey questionnaires. The items identified during all the task force meetings were compiled as qualitative data to be analyzed in conjunction with social indicators and survey data. B. The Social Indicator Method Social indicators including demographic, socioeconomic and health related statistics were obtained both locally and nationally. These indicators included several demo­ graphic characteristics of the population in the community (e.g., age distribution, mortality and morbidity); economic characteristics ethnic make-up); (e.g., socio­ poverty rate and racial/ and certain health related statistics * (e.g., amount and types of health care needed by the people in the community). The sources of the data included a recently conducted United Hay Needs Assessment of Saginaw County, Inc., October, 1985), (United Hay the State Health Plan: 1983-87 1983), the Institute of Medicine Study (Institute of Medi­ cine, (Statewide Health Coordinating Council, 1983), and the 1980 Census Research, (Bureau of Business School of Business Administration, Hayne State 74 University, 1983). Data were also drawn from other sources as they were discovered. Efforts were made to draw data from the most currently available sources. The social indicators from the local area were com­ pared with national indicators. these indicators, The discrepancies between when appropriately interpreted, served as a standard (what should be) as needs were determined. The social indicators were also used to identify needed revi­ sions in the survey questionnaires. The next section deals in-depth with each survey method employed. C* The Survey Method The three surveys conducted for this study were of the following groups: students registered nurses, the current SVSC (these two surveys were compiled later as poten­ tial student survey) and potential employers* This section describes the procedures used for each of the three sur­ veys. The procedures required to ensure protection of human subjects were followed for all three surveys accord­ ing to the rules set by both Saginaw Valley State College (Appendix C) and Michigan State University (Appendix D ) . A letter of transmittal that accompanied each questionnaire Included a statement that indicated the voluntary nature of participation in the survey and an assurance of anonymity. 75 1■ Survey of Registered Nurses. Sampling Design: One survey was conducted with the registered nurses as potential students of the proposed MSN progam. The popula­ tion for the RN survey was identified as all baccalaureateprepared nurses (BSNs) or RNs who are currently pursuing BSN degrees within 50 miles of SVSC. Because such a samp­ ling frame was not available* a cluster sampling method was used in order to identify the subjects. Using a cluster sampling method limited our samples to those who were associated with either a place of employment or being enrolled in the baccalaureate program. However, it was felt that the use of this method was justified because these were the type of RNs who would more likely pursue MSN degrees. A single stage cluster sampling design was used, designating each health agency as a cluster. sample clusters, In order to a stratified random sampling method was used, designating each type of health care agency as a stratum. This was necessary because the number of BSNs (and those who are pursuing the BSN degrees) according to the type of health care agency. care agencies agencies differed The acute tended to employ more BSNs than those that were more removed from acute care. Determination of Sample S i z e : Determination of an appropriate sample size is one of the essential steps for the efficient survey. 76 A larger sample does not necessarily increase Che degree of preci­ sion in estlmacing Che populaClon parameters. In order to determine a sample size that maximized the precision and minimized the bias in estimating the population parameters the following standard formula for determining the sample size for stratified sampling method (Raudenbush, 1985) was used: L - m 2 A 2 M i * &i ~ ( £ m±)2(b2) + £ m ±. 6 * where: L - overall sample size (sample # of BSNs) - size of population in the stratum i ^ - population standard deviation In stratum 1 - proportion of population in stratum 1 in comparison to the total population B - bound of error [To determine the bound of error, let B be 10Z of 6 » Because I am dealing with dlchotomous variable, via worst case planning, 6 ■ .5, therefore B * 0.1 x 0.5 ■ 0.05 C.X.: (.475, .525)1 The procedure for estimating the sample size and determination of the number of clusters found in Appendix E. 77 (agencies) will be From this formula, determined to be 268. Che total number of subjects was The number of clusters (agencies) to be selected were then Identified according to the types of health care agencies (strata). Six strata were Identified. The number of agencies to be chosen from each stratum was then determined according to the estimated number of BSNs and potential BSNs In each stratum. The following chart shows the six strata and the num­ ber of agencies to be selected from each stratum. Number of Agencies Selected Medium size hopsitals Small size hospitals Health departments/visiting nurses associatIons Home care agencies Nursing homes Schools of nursing Industry 8 11 7 6 13 1 L A total of 47 agencies were identified as the sites for the Registered Nurse Survey. Subjects: The respondents of the registered nurse survey were identified as follows: 1. A registered nurse with a BSN degree or who is currently enrolled In the BSN program. 2. Employed in the sample health care agencies within 50 miles from SVSC. 78 Instrument: A twenty-four Item, self-administered questionnaire: Nursing Education Survey was developed for the registered nurse survey (Appendix F ) . The questionnaire consists of the following major sections: • Professional Nursing Background, • Educational Background, • Future Educational Plans, and • Demographic Background. In the process of constructing the questionnaire, careful attention was given to Include items which would provide information regarding the respondents' the proposed program, Interest in the preferred area of concentration in study, and the functional role of nursing that would be preferred to study* Other information included, preferred method of enrollment such as full- or part-time study, the . preferred semesters to enroll, which days of the week/how many days a week preferred to attend classes, distance to commute to SVSC* and the The demographic data were Included to identify the characteristics of the respon­ dents . Babble (1973), and Sudman and Bradburn (1983) were used as guides for constructing and designing the ques­ tionnaire. The major guidelines followed were: 79 1. 2. 3. 4. 5. Do not clutter the questionnaire. State questions clearly. Hake It easy for the respondents to read and answer. Precode the Items for ease of analysis. Provide areas to write Individual comments. A letter of transmittal written on the SVSC letter­ head and signed by the Dean of the School of Nursing and Allied Health explained the Intent of the study, when and how to return the questionnaire, participation, the voluntary nature of and assurance of anonymity (Appendix 6). A self-addressed buslness-return type envelope and a post card were Included with the questionnaire (Appendix H). The post cards were provided for the respondents to indicate their interest in the proposed program and to receive correspondence from SVSC. The instrument was pilot tested by seven members of the SVSC Alumni Task Force group. These individuals were similar in academic and professional background. As pilot respondents to this survey they provided valuable suggestlons for revisions and additions to the questionnaire. Procedure: Prior to the distribution of the surveys sampled health care agency, to each telephone contacts were made with the director or vice president of nursing to explain the Intent of this study and request approval for the distribution of questionnaires. Each of the sampled agencies agreed to participate initially except for two 80 agencies. Additional information was sought by these agencies before they agreed to participate (Appendix I). A set of envelopes which contained a questionnaire, a letter of transmittal and a post card were distributed to each sample agency within a 30 mile radius by SVSC person­ nel. The envelopes by mall. for agencies outside 30 miles were sent A letter was sent to each sample agency explain­ ing to whom the questionnaires should be distributed and details related to their return (Appendix J). Each questionnaire was coded with an agency identifi­ cation number. the mail, As the questionnaires were returned through the patterns of return were observed. This procedure permitted the identification of agencies with low questionnaire return rates. The identified agencies were contacted by telephone and asked to remind the subjects to respond as soon as possible. Questionnaire Retrieval; A total of 612 questionnaires were sent to the sample agencies. Appendix K shows the number of questionnaires distributed and those completed and returned. Approxi­ mately 200 questionnaires were returned within three weeks. Agencies with no questionnaires returned or a low return rate within three weeks were Identified by the coding system, and were contacted by phone. A designated indi­ vidual was asked to remind the subjects to return the questionnaires. An additional 15Z increase in the return rate was obtained using this method. 81 A total of 303 questionnaires were returned two months after their distribution, 49.51Z. thus the overall return rate was The questionnaire return rate from the agencies within 30 miles from SVSC was 56.5Z, while 30-50 miles from SVSC was 38.8X. those between Table 3 shows the ques­ tionnaire return rate according to type of agency. 82 TABLE 3. MSN HEEDS ASSESSMENT QUESTIONNAIRE— RETURN RATE BT THE TYPE OF HEALTH CARE AGENCIES (POTENTIAL STUDENTS - RN'S). Type of Health Care Agency MH (Medium Size Hospitals) Bed # over ISO Number Distributed Number Returned Percent Returned 392 185 47.2 SH (Small Size Hospitals) Bed 0 less than 150 96 37 38.5 HD (Health Dept. VN A) 47 34 72.3 HC (Home Care Agencies) 18 3 16.7 NK (Nursing Homes) 23 9 39.1 Other: 32 30 93.8 RN Students Community College 83 2. The Survey of the Currently Enrolled Surging Students. Two subgroups Included In the survey at SVSC were, RN students (1) (who are registered nurses), and (2) generic students (who are not registered nurses). All students currently enrolled in the SVSC nursing program were ashed to participate in the survey I ns tr um en t: The Registered Nurse Survey was used for the RN stu­ dents (see Appendix F). was constructed A separate 16-item questionnaire for the generic students (see Appendix L). Several of the questions Included In the Nursing Student Survey contained the same questions ashed in the Registered Nurse Survey. The questions unique to generic students related primarily to their plans for future employment and continuing education. The Nursing Student Survey was pilot-tested on a group of five junior nursing students who volunteered. They reported that the instrument was clear and they had no difficulty understanding the questions. No change was suggested by this group. Procedures: Questionnaires accompanied by a letter of transmittal (Appendix M and N), similar to the one accompanied the Registered Nurse Survey, were distributed to the nursing students in class during the first weehs after the spring breah (March, 1986). The course instructors were ashed to 84 administer the questionnaire during the first ten minutes of their class Immediately. time. The questionnaires were collected The RN students were asked not to participate if they had already completed the questionnaire in their place of employment. Again, explained. the voluntary nature of their participation was Anonymity was also maintained by asking the students not to Identify their questionnaires by name, or by any other identifying mark. 3• Survey of the Potential Employers. The health care agencies within 50 miles of SVSC were identified as potential employers of graduates of the posed MSN program. pro­ All agencies selected as sampling clus­ ters for the Registered Nurse Survey were studied (N"47). The names of the agencies were obtained from the list pro­ vided by the Michigan Department of Public Health as health care agencies (Michigan Department of Public Health, The types of agencies Included hospitals, agencies, mental health facilities, of nursing, 1985). community health nursing homes, schools and Industry. Inatruaent; The questionnaire for the potential employers was formulated on the local and national trends in nursing and the health care system, along with Issues, concerns and questions raised by the Community Task Force Group. Potential Employer Survey can be found in Appendix 0. The The questions addressed in this survey Included the following: 1. The number and educational background of the registered nurses employed by the agency, 2• If any of the current positions require or prefer MSN background; 3. If any vacancy exists listed under #2, 4. If the agency Intends to employ the graduates of the proposed MSN program, 5. Area of specialties and functional roles that meet the needs of the agency, 6. Type of information/toplc important to the agency, 7. What type of incentives the agency would offer to the students, and 8. What type of resources the agency can provide for the proposed pro­ gram. In the positions The instrument was tested at the meeting of the area Directors of Nursing held in January, those who attended wrote comments suggested revisions 1986. A number of for each question and for clarity and ease of response. questionnaires were revised according provided. 86 The to the suggestions Proce d ur e: The questionnaire accompanied by a letter of trans­ mittal (Appendix P), similar to those which accompanied the other two survey questionnaires were mailed to each Direc­ tor of Nursing in the sampled health care agencies. A business return envelope was enclosed for returning the questionnaire. The agencies were asked to return the questionnaires within 5-7 days. The questionnaires for this survey were coded to verify their return. The agencies which did not return the instrument after thirty days were sent a second set of questionnaires. 87 METHODOLOGY FOR EVALOATIOH This section describes how the needs assessment process was evaluated. Using the standards defined by the Joint-Committee on Standards for Educational Evaluation as a conceptual conducted Phaae I: framework, the evaluation for this study was in the following three phases: Phase I: Evaluation of the preparation phase Phase II: Evaluation of the implementa­ tion phase Phase Evaluation of the outcome III: Evaluation of the Preparation Phase Before conducting a needs assessment, tion must occur. careful prepara­ The evaluation of the prepara.tion phase Involves examination of the proposal as well as the plans to manage the process of the proposal. The evaluation was conducted by the researcher working closely with the Dean of the School of Nursing and Allied Health. uals with a Ph.D., research, one with a background in institutional and another in social research were consulted before the surveys were conducted. titled: Two individ­ Questions A set of questions for Evaluating A Needs Assessment, pared by Stufflebeam (1985, pre­ p. 197) were used to evaluate this phase of the needs assessment. These include a set of questions listed under each of the following major head­ ings : 88 1. 2. 3. 4. 5. 6. Phase XI: Conceptualization of needs assess­ ment, Sociopolitical factors, Contractual/legal ar ra n g e m e n t s , Technical design, Management plan, Moral/ethical/utility questions Evaluation of the Implementation Phase Periodic checks should be made on how well the needs assessment is being implemented (Stufflebeam, p. 95). et a l . , 1985, During the course of needs assessment from Decem­ ber to June 1986, the researcher met with the Dean of the School of Nursing and Allied Health weekly, reflecting on the previous week's progress of the study, and discussed the plans for the following week. The key question addressed during these meetings was: needs assessment being implemented? How well was the Notes were kept by both parties on the informal feedbacks received from the prospective students, Phase III; agency personnel and college staff. Evaluation of the Outcome The evaluation of the outcome addresses the question: How good and valuable was the needs assessment? In terms of the Joint Committee's standards, was it useful, practi­ cal, p. 195)? proper, and valid Based on the standards, (Stufflebeam, et al., 1985, four major questions were posed as f o ll ow s: 1. Has the information reported appro­ priately? 2. Was the study carried out appropri­ ately? 89 3. Were the rights of the persons affected by the study protected? 4. Has the study produced sound informa­ tion? Thirty standards and their descriptors prepared by the Joint Committee were used to answer the above questions. * In applying the standards, "Standard Criterion Form", provided by Stufflebeam, et al. (1985, p. 190) was used. The Criterion Form was completed by the researcher based on data collected from several sources, including notes from the evaluation of Phase I and IX, as well as, the Dean's overall appraisal of the study. A separate evaluation form was created by the researcher for the Dean's evaluation (Appendix Q). 90 SUMMARY OP METHODOLOGY This chapter described the design of the study and the methodology used needs assessment* for implementation and evaluation of the The three methods this needs assessment employed were the task force group, survey. social Indicator and Three types of surveys used for this study were, the Registered Nurse Survey, the Nursing Student Survey and the Potential Employer Survey. Sampling methodology and procedures for each of the surveys were explained. The methodology for evaluation of the needs assessment was also described. preparation, The evaluation was conducted in three phases: implementation and outcome. will describe the results of this study. 91 The next chapter CHAPTER I V : RESULTS This chapter is divided into the following sections; the first section presents the results of the needs assess­ ment including the surveys, task force groups, and social indicators, and the second section presents the results of the evaluation of the needs assessment. SECTION ONE: THE RESULTS OF THE HEEDS ASSESSHBHT The results of the needs assessment are presented in the following order: surveys, social Indicators. 92 task force groups, and THE RESULTS OF THB SORVEYS The summary of the three surveys: Nurse (RN) Survey, The Registered the Nursing Student Survey, and Poten­ tial Employer Survey will be presented in this section. Three separate questionnaires were administered to each of the survey groups. Among the questions asked In the Registered Nurse Survey and the Nursing Student Survey, some questions applied only to the R N s , some questions applied only to the nursing students, while several other questions applied to both RNs and nursing students. Therefore, these two surveys will be reported together according to three groupings of questions as follows: A. B. C. Questions RNs , Questions nursing Questions nursing which apply only to the common to both the RNs and students, which apply only to the students. A total of 291 registered nurses (RNs) responded to the Registered Nurse Survey, and 97 generic nursing students responded to the Nursing Student Survey. The respondents of the Registered Nurse Survey consist of 263 RNs employed in the area health care agencies and 28 RN students who are currently enrolled In the BSN program at SVSC. The former group was sampled from the RNs from the area health care agencies using a cluster sampling. latter group consisted of all RN students at SVSC. The Because different sampling methods were used for the above two groups, data for these groups will be presented separately. However, the summary statistics of all the RN respondents will also be provided for descriptive purposes. The Survey of the Potential Employers will be reported In the last part of this section. 94 THE RESULTS OP THE QUESTIONS THAT ONLY APPLY TO THE REGISTERED HURSES There were 24 items in the RN survey questionnaire. The first eight questions in this questionnaire applied only to the- RNs. These questions dealt with the respond­ ent's professional and educational background. The follow­ ing section will report the summary of the results for each of these questions responded to by the sample RN group and the RN student group. dents The statistics for all RN respon­ (composite of the above two groups) will also be shown for descriptive purposes. 95 1. How many years have you been In practice as a registered nurse? RN Sample Group Years of Practice 9 1 year or less 2-4 years 5-10 years 11-15 years 16-25 years 25 years or more Total Responses X 19 68 73 38 35 10 243 ( ( ( ( ( ( RNs at SVSC X # ( 0.0) ( 0.0) ( 57.1) C 25.0) ( 14.3) ( 3.6) 19 68 89 45 39 11 28 (100.0) 271 # 7.8) 28.0) 30.0) 15.7) 14.4) 4.1) (100.0) Al1 RNs 0 0 16 7 4 1 X ( ( ( ( ( ( 7.0) 25. 1) 33.1) 16.5) 14.3) 4.0) (100.0) • As shown in the above chart, the years of practice between 5 to 10 years are the modal category for all three respondent groups. • The next most frequent response cate­ gory was that of 2-4 years for the RN sample group and the all RN respondent group . • Among the RN student group, the second most frequent response category was that of 11-15 y e a r s . 2. In what type of setting are you currently employed? RN Sample Group 9 X 200 ( 82.0) 37 ( 15.2) Hospital Community health agencies Long-term care agencie s Educational facilities Not employed Total Responses 244 RNs at SVSC 9 X 24 ( 85.7) 0 ( 0.0) All RNs 9 X 224 ( 82.3) 37 ( 13.6) 3 ( 1.2) 0 ( 0.0) 3 ( 1.1) 4 ( 1.6) 0 ( 0.0) 4 ( 1.5) __ 0 ( 0.0) ( 14.3) __ 4 ( 1.5) 96 (100.0) _4 28 (100.0) 272 (100.0) • As shown above over 80% of the respondents are employed by hospitals. • Those who are employed In long-term care facilities or eduatlonal facilities are only a small fraction of the total RN respondents. 3. What is your current position in your employment RN Sample Gr oup X # Staff or charge nurse Head nurse Pt. care coor­ dinate r Asst, director of nursing Director of nursing Educator Other Not employed Total Responses 244 setting? RNs at SVSC # X All RNs X # 160 ( 65.6) 17 ( 60.7) 177 ( 65.1) 19 ( 7.8) 30 < 12.3) 1 ( 3.6) 3 < 10.7) 20 ( 7.4) 33 ( 12.1) 3 ( 1.2) 1 ( 3.6) 4 ( 1.5) 5 ( 2.0) 0 ( 0.0) 5 ( 1.8) 19 ( 8 ( __ 0 ( 7.8) 3.3) 0.0) 2 ( 7.1) 0 ( 0.0) 4 ( 14.3) 21 ( 8 ( __ 4 ( 7.7) 2.9) 1.5) ( 100.0) 28 (100.0) • By far, the category of staff nurse or charge nurse shows the largest number of responses across all three response groups. • The patient care coordinator or manager positions which traditionally had been called supervisors is ranked as second most frequent, followed by the head nurse position and the nurse educator. 97 272 (100.0) 4. What is your clinical specialty area? RN Sample Group # X Adult Medical-Surgical Critical care or emergency room Parent-child health Community health Psychiatric-Mental Health 106 ( 43.6 67 ( 27.6 Total Responses 243 (100.0 33 ( 13.6 27 < 11.1 10 ( 4.1 • Adult medical-surgical specialty is the most frequently responded category. • Critical care and emergency room category was the next category. • The data from the RN student group and all RN respondent group were omitted. The pattern of clinical specialty area remained similar across all three response groups . (Part I) What is the type of your initial nursing education? RN Sample Group RNs at SVSC All RNs # X 9 X 9 X Diploma Assoc. Degree BSN LPN 40 54 141 __ L ( 16.4) ( 22.1) ( 61.1) ( 11 17 0 0 ( 39.3) ( 60.7) ( 0.0) ( 0.0) 51 71 149 1 ( 18.7) ( 26.1) ( 54.8) ( 0.4) Total Responses 244 (100.0) 28 (100.0) • The RN sample group data revealed that 6 1 . IX of the respondents had a BSN as their initial nursing education. 98 272 (100.0) • The data for Che RN student group revealed that 39.3% had a diploma and 60.7% had an associate degree as their Initial nurs­ ing education. 5. (Part 2) What completed? Is the year your initial nursing education was RN Sample Group 1950 1960 1970 1980 thru thru thru thru 1959 1969 1979 1986 Total Responses # % 12 34 80 118 ( 4.9) ( 13.9) < 32.8) ( 48.4) 244 (100.0) RNs at SVSC # 1 3 19 _5 All RNs % 4 % ( 3.6) ( 10.7) ( 67.8) ( 17.9) 13 37 99 123 ( 4.8) ( 13.6) ( 36.4) ( 45.2) 28 (100.0) 272 (100.0) • It Is evident from the above chart that 48.8% of the RN sample group had completed their Initial education between 1980 and 1986. On the ocher hand, only 17.9% of the RN students responded that between 1980 and 1986 that their initial nursing education had been completed. e Sixty-seven percent of the RN student group responded that they had completed their Initial nursing education between 1970 and 1979. • For all RN respondents, over 80% responded that they completed their Initial nursing education between 1970 and 1986. 99 6. What is the highest degree you hold? RN Sample Group RNs at SVSC X # Di ploma AD BSN BA Human Services BA Guidance Other 16 31 185 2 1 __ 7 Total Responses 242 (100..0) ( 6..6) ( 12,.8) ( 76,.5) ( 0,►8) C 0,,4) ( 2..9) # X 11 17 0 0 0 0 ( 39 .3) < 60 .7) ( 0 .0) ( 0 .0) ( 0 .0) ( 0 .0) 28 (100 .0) All RNs X # 27 48 185 2 1 __ 7 ( 10.0) ( 17.8) ( 68.5) ( 0.7) ( 0.4) ( 2.6) 270 (100.0) • The response pattern for the above question was similar to that of question #5 (part 1), except for the RN sample group. • The RN student group was currently pursu­ ing the BSN degree and do not have a higher degree in other fields. 7. Are you currently enrolled in any of the following educa­ tional programs? RN Sample Group BSN MSN Master, Health Service Ada. Master, Health Ed. MBA Master, Public Adm. Master, Non-Specif led Other 41 ( 63.0) 5 ( 7.7) 2 ( 3.1) Total Responses 65 RNs at SVSC 28 (100.0) 0 ( 0.0) 0 ( 0.0) All RNs 69 ( 74.1) 5 ( 5.4) 2 ( 2.2) ( ( ( ( 7.7) 4.6) 3.1) 3.1) 0 0 0 0 ( ( ( ( 0.0) 0.0) 0.0) 0.0) 5 3 2 2 ( ( ( ( 5.4) 3.2) 2.2) 2.2) 5 ( 7.7) _0 ( 0.0) __5 ( 5.4) 5 3 2 2 (100.0) *Roundlng error. 100 28 (lOO.'O) 93 (100.1) • Note that only 93 of the 291 RN respondents and 65 of the 244 RN sample respondents answered this question. • Of those who responded. It Is evident from the above chart that the BSN program Is the most popular educational degree program for all respondent groups. 8. Do you plan to be enrolled In any of the following academic programs within the next three years? RN Sample Group RNs at SVSC All RNs 9 X 9 X 9 BSN BA Business BS Health Education MSN Master, Health Science Master, Non-Speclfled Master, Health Educ. MBA Master, Public Adm. Don't know Other 15 8 4 130 1 2 5 6 2 1 __ 5 ( 8.3) ( 4.5) < 2.2) ( 72.6) ( 0.6) ( 1-1) ( 2.8) ( 3.4) ( 1.1) ( 0.6) ( 2.8) 5 0 0 16 0 0 0 2 0 0 0 ( 21.7) C 0.0) ( 0.0) ( 69.6) ( 0.0) C 0.0) ( 0.0) < 8.7) ( 0.0) ( 0.0) ( 0.0) 20 8 4 146 1 2 5 8 2 1 5 < 9.9) ( 3.9) ( 2.0) ( 72.3) ( 0.5) 1.0) ( 2.5) < ( 3.9) ( 1.0) ( 0.5) ( 2.5) Total Responses 179 (100.0) 23 (100.0) 202 (100.0) • As noted In the above chart, an MSN pro­ gram Is by far the most frequently m e n ­ tioned category across all three respond­ ent groups. • Completing the BSN degree requirements is the next highest category, again across "all three groups. • It should be noted that the respondents of the RN sample group have a more diverse choice of masters degree than the RN stu­ dent group. 101 X THE RESPONSES TO QPESTIOHS COMMON TO BOTH RNs AMD HORSING STUDENTS Questions #1 through #8 of the Registered Nurse Survey address their professional and educational backgrounds. remaining questions (#9 through #22) dents' The relate to the respon- . interests toward the proposed MSN program and their demographic backgrounds. The Nursing Student Survey also had the identical items in the questionnaire. The following section reports the results of these questions Included in both the RN Survey and the Nursing Student Survey. Question #9: Do you have all of the qualifications (for the proposed MSN program)? #14 of the Nursing Student Survey The qualifications for the proposed MSN program are identified in the question­ naire as follows: • Baccalaureate degree in nursing from a NLN accredited institution • Undergraduate GPA of 3.0 or higher (on a 4.0 point scale) • License to practice as a registered nurse in the State of Michigan • Documented competence in nursing practice through references 102 The following chart shows the data for the status of meeting the above qualifications by five survey respondent groups, i.e., (3) a l l R N (1) RN sample group, respondent group, (2) RN student group, (4) nursing student group, and (5) composite of RN and nursing student (SN) respondents. RN Sample Group Currently meet s qualifi­ cations Will meet qualfications in 2-3 yrs 177 ( 74.1) RNs at SVSC 3 ( 10.7) 180 ( 67.4) 59 ( 61.5) 35 ( 14.6) 22 ( 78.6) 57 ( 21.4) Not ready _J27_ ( 11.3) _3 in 2-3 yrs Total Responses All RNs 239 (100.0) ( 10.7) 28 (100.0) Nursing Students 29 ( 30.2) 30 ( 11.2) _8 273 (100.0) ( 239 < 65.8) 86 ( 23.7) 8.3) __3£ ( 10.5) 96 (100.0) • Approximately 742 of the RN sample respon­ dents reported that they currently meet the qualifications for the proposed MSN pro­ gram. This percentage is reduced as all response groups are considered. 103 RN SN Survey Composite 380 (100.0) 10. Would you enroll In the masters degree program In nurs­ ing If It were available at SVSC within the next 2-3 years? RN Sample Group RNs at SVSC All RNs Nursing Students RN SN Survey Comp os ite Yes No 180 _6£ ( 74.4) 21 ( 75.0) ( 25.6) _7 ( 25.0) 201 ( 74.4) _69_ < 25.6) 67 310 ( 69.1) 268 ( 73.0) ( 30.9) _99_ ( 27.0) Total Responses 242 <100.0) 28 (100.0) 270 (100.0) 97 (100.0) 367 (100.0) • As noted above over 69X of the respondents marked "yes". • Of 242 respondents of the RN sample group, 74.42 responded that they would be inter­ ested in the proposed program. • Seventy-five percent of the RN students marked "yes", while 69.12 of the generic nursing students did likewise. The following chart shows the complete breakdown of answers to this question for all the RN respondent group. YES Definitely YES Maybe No plan to go on Not ready within 2-3 year s Plans to go elsewhere Moving from area Has MSN Not specified Interested if off campus 46 168 51 12 Total 288 (100.0) 104 2 2 2 4 1 ( 16.0) ( 58.3) ( 17.7) ( 4.2) ( ( ( ( ( 0.7) 0.7) 0.7) 1.4) 0.3) • It should be noted from this sample that 46 of 288 respondents (16.OX) reported they will definitely enroll if the program came Into existence. Approximately 58X of them answered "yes, maybe" while the remaining 25.6X reported that they will not be enrolled for one reason or another. 11. What speciality area would you choose to study in the MSN program? RN Sample Group RNs at SVSC All RNs Nursing Students RN SN Survey 'Composite # Adult medical-surglcal Parentchild health Community health Psychmental health Undecided Total Responses X 106 ( 58.2) 9( 40.9) 115 ( 56.4) 27 ( 39.1) 142 ( 52.0) 34 ( 18.7) 5( 22.7) 39 ( 19.1) 26 ( 37.7) 65 ( 23.8) 31 ( 17.0) 4( 18.2) 35 ( 17.1) 4( 5.8) 39 ( 14.3) 9( 5.0) 2( 9.1) 11 ( 5.4) 5( 7.3) 16 ( 5.9) 2.0) _7 ( 10.1) 11 ( 4.0) ___ 2 ( 1.1) _2 ( 182 (100.0) 9.1) ___4 ( 28 (100.0) 204 (100.0) 69 (100.0) • As noted on the chart above, adult medicalsurgical nursing is the most preferred specialty across all repsondent groups. • Adult medical-surgical specialty Includes gerontology, oncology and nursing adminis­ tration as specified by some of the res pondents. • Parent-chlld health nursing is the next highest category of preference across all the respondent groups. • Note that the order of preference is fairly consistent across all repsondent groups. 105 273 (100.0) 12. What functional role are you interested in learning the MSN program? RN Sample Group # 92 Clinical Nurse Specialist Nurse Admin­ 42 istrator Nurse Edu­ 42 cator Nurse 1 Researcher Not spec. __ 2 total Responses X RNs at SVSC All RNs X # X in Nursing Students tf RN SN Survey Compos i te X X (51.4) 10 ( 43.5) 102 ( 50.5) 36 ( 51.4) 138 ( 50.7) (23.5) 5 ( 21.7) 47 ( 23.3) 13 ( 18.6) 60 ( 22.1) (23.5) 5 ( 21.7) 47 ( 23.3) 17 ( 24.3) 64 ( 23.5) ( 0.5) 0 ( ( 1.1) 179 (100.0) 1 ( 0.4) 0 ( 0.0) 1 ( 0.4) _3 ( 13.1) __ 5 ( 2.5) 4 ( 5.7) __ 9 ( 3.3) 23 (100.0) 202 ( 100.0) 0.0) 70 (100.0) • As noted in the above c h a r t , the clinical nurse specialist role is the most popular functional role chosen by the respondents across all respondent groups. • The preference for a nurse administrator and a nurse educator role are similar across the respondent groups except for the nursing student group who chose nurse administrator role as more favorable than nurse educator role. • Only one respondent chose researcher role. 106 the nurse 285 ( 100.0) 13. When you are to be enrolled In the proposed Masters degree In Nursing program, you will enroll full-time or part-time? RN Sample Group 0 Full-time Part-time Total Responses X 0 13 ( 7.1) JL70, ( 92.9) 183 RNs at SVSC (100.0) X All RNs 0 X RN SN Survey ComposIte Nursing Students 0 X 0 Z 2< 9.1) 20 ( 90.9) 15 ( 7.3) m . ( 92.7) 4( 5.7) 66. ( 94.3) 19 ( 6.9) 256, ( 93.1) 22 (100.0) 205 (100.0) 70 (100.0) 275 (100.0) • By far, the majority (over 90Z) of the respondents preferred their graduate studies on a part-time basis. • The preference for a part-time study is consistent across all the respondent groups. 14. When you are to begin the proposed masters degree pro­ gram, would you prefer to be enrolled in (semesters): RN Sample Group X 0 Fall/Winter 84 79 All four semesters Fall/Winter/ 12 Spring Fall/Spring 1 Spring/Sum­ 1 mer Summer I Dont' know __ 3 To tal Responses 181 ( ( 46.4) 43.6) RNs at SVSC X # 11 ( 47.8) 10 ( 43.5) A 1 1 RNs X # Nursing St udents 0 X RN SN Survey Compos ite 0 X 95 ( 46.5) 36 ( 52.2) 131 ( 48.0) 89 ( 43.6) 30 ( 43.5) 119 ( 43.6) ( 6.6) 1 ( 4.4) 13 ( 6.4) 0 ( 0.0) 13 ( 4.7) ( ( 0.6) 0.6) 0 ( 1 ( 0.0) 4.4) 1 ( 2 ( 0.5) 1.0) 0 ( 0 ( 0.0) 0.0) 1 ( 2 ( 0.4) 0.7) ( ( 0.6) 1.6) 0 ( 0 ( 0.0) 1 ( 0.0) __ 3 ( 0.5) 1.5) 0 ( 3 ( 1 ( 0.0) 4.3) __ 6 ( 0.4) (100.0) 23 (100.0) 204 (100.0) 69 (100.0) • As noted above, the “Fall and Winter" is the modal category across all respondent groups. 107 273 2.2) (100.0) • The next most preferred category is "All Semesters" category* • The least preferred category Is "Summer" or "Summer and Spring". IS. Which of the following days of the week are most con­ venient for you to commute to SVSC? RN Sample Group # Two evenings 70 per week One day per 58 week, 6 hrs Two after­ 21 noons per week Every other 20 Friday Two mornings 5 per week One evening, 1 6 hrs Weekends 1 No prefer­ 3 ence Don't know __ 2 Total Responses 181 X RNs at SVSC # X All RNs 9 Nursing Students if X X RN SN Survey Composite X if ( 38.7) 4 ( 18.2) 74 ( 36.5) 16 ( 23.2) 90 ( 33. 1) ( 32.0) 13 ( 59.1) 71 ( 35.0) 27 ( 39.1) 98 ( 36.0) 15 ( 21.7) 36 ( 13.2) ( 11.6) 0 ( 0.0) 21 ( 10.3) ( 11.0) 4 ( 18.2) 24 ( 11.8) 2 ( 2.9) 26 ( 9.6) ( 2.7) 0 ( 0.0) 5 ( 2.4) 2 ( 2.9) 7 ( 2.6) ( 0.6) 0 ( 0.0) 1 ( 0.5) 0 ( 0.0) 1 ( 0.4) ( ( 0.6) 1.7) 0 ( 0 ( 0.0) 0.0) 1 ( 3 ( 0.5) 1.5) 0 ( 0 ( 0.0) 0.0) 1 ( 3 ( 0.4) 1.1) ( 1.1) 1 ( 4.5) __ 3 ( 1.5) 7 ( 10.1) (100.0) 22 (100.0) 203 (100.0) 69 (100.0) • As shown above two evenings per week seems to be the category most preferred by all the respondent groups. • One day per week (6 hours) preferred category. is the next most • Every other Friday and two afternoons per week were also chosen by some of the respondent groups. • Only 1-2 of the respondents preferred have class on weekends. 108 to 10 272 ( 3.6) (100.0) 16. From your residence, to SVSC? how far would you need RN Sample Group Z # 1-20 miles 21-30 miles 31-40 miles 41-50 miles 50 miles or more Total Response s 75 27 27 24 31 RNs at SVSC ( ( ( ( ( 40.8) 14.7) 14.7) 13.0) 16.8) 184 (1 00.0) # % 6 2 0 5 10 ( 26.1) ( 8.7) ( 0.0) ( 21.7) ( 43.5) 23 (1 00.0) All RNs Z # 81 29 27 29 41 ( ( ( ( ( to travel Nursing Students Z # 39.1) 37 ( 51.4) 14.0) 12 ( 16.7) 8 ( 11.1) 13.1) 14.0) 3 ( 4.1) 19.8) 12 ( 16.7) 207 (100.0) RN SN Survey ComposIte 72 (100.0) # 118 41 35 32 53 Z (42.3) (14.7) (12.5) (11.5) (19.0) 279 (100.0) • Nearly 40-50JE of the respondents reported that they live within 20 miles of the com­ muting distance except for the RN student group. • Forty percent of the RN student group live beyond 50 miles of the commuting distance. • The proportions for the 21-30 mile, 31-40 mile and 41-50 mile category are fairly even at 10-14Z. 17. Sex of the respondents: RN Sample Group if Z RNs at SVSC # Z All RNs # Z Nursing Students # Z RN SN Survey Composite & % Male Female 8( 3.5) 218 ( 96.5) 0 ( 0.0) 26, (100.0) 8( 3.2) 244, ( 96.8) 8( 8.4) 87, ( 91.6) 16 ( 4.6) 33J, ( 95.4) Total Responses 226 (100.0) 26 (100.0) 252 (100.0) 95 (100.0) 347 (100.0) • It is evident from the above chart that the respondents are predominantly female. • Note that the RN Nursing Student Survey com­ posite data shows that 17 of 363 respondents are male. 109 18. Age of the respondents: RN Sample Group RNs at SVSC All RNs 9 Z 9 18-25 26-35 3 6-4 5 46-55 Over 55 39 119 48 18 __ 1_ ( 17.3) ( 52.9) ( 21.3) ( 8.0) ( 0.4) 1 17 5 3 0 Total Responses 225 (100.0) 26 (100.0) 231 Z Z # 40 ( 3.9) 65.4) 136 ( 33 C 19.2) 21 ( 11.5) ( 0.0) __ 1_ Nursing Students 9 Z ( 15.9) ( 54.2) ( 21.0 ( 8.4) ( 0.4) 76 13 6 0 0 (100.0) 95 (100.0) RN SN Survey Composite 9 z ( 80.0) 116 ( 35.6) ( 13.7) 149 ( 45.7) 39 ( 12.0) ( 6.3) 21 ( 6.4) ( 0.0) ( 0.0) __ 1_ ( 0.3) 326 (100.0) • As shown In the above c h a r t , the modal category for each of the response groups Is the ages between 26 and 35 except for the generic nursing student group whose modal category Is the ages between 18 and 25. 19. Race of the respondents: RN Sample Group 9 White Black Spanish American Indian Orlental Total Responses 217 4 1 1 Z (96.9) ( 1.8) ( 0.4) ( 0.4) __ 1_ ( 0.4) 224 RNs at SVSC 9 26 0 0 0 All RNs Z # (100.0) ( 0.0) ( 0.0) ( 0.0) 243 4 1 1 0 ( o.o) (99.9)* 26 (100.0) Z 9 0.4) (100.0) 0 ( RN SN Survey Compos 1 te 9 % 349 4 1 4 ( 96.9) 1.1) ( ( 0.3) 1.1) ( 0.0) __ 2 ( 94 (100.0) 360 *Rounding error. • The above chart shows that the race of the respondents Is predominantly white.' • Blacks and American Indians are only 1.1Z each of the total respondent population. • Spanish and Oriental are 0.3Z and 0.635 of the total respondent population. 110 Z ( 97.2) 91 ( 96.8) 1.6) 0 ( 0.0) ( 0.4) 0 ( 0.0) ( 3 < 3.2) ( 0.4) 1 ( 250 Nursing Students 0.6) (100.0) 20. Marital status of the respondents: RN Sample Group # % RNs at SVSC # % Nursing Students All RNs # % it % RN SN Survey Compos ite it % 113 213 16 2 __ i_ ( 32.8) ( 61.8) ( 4.6) ( 0.5) ( 0.3) Single Married Divorced Widowed Separated 47 161 15 1 __ 0 50 ( 20.0) ( 21.0) 3 ( 11.5) ( 71.9) 22 ( 84.6) 183 ( 73.2) 0 ( 0.0) 15 ( 6.0) ( 6.7) 0 ( 0.0) ( 0.4) 1 ( 0.4) 1 ( 3.9) __ 1_ ( 0.4) ( 0.0) 63 30 1 1 0 Total Responses 224 (100.0) 95 (99.9)* 345 26 (100.0) 250 (100.0) (66.3) (31.6) ( 1.1) ( 1.1) ( 0.0) (100.0) *Rounding error. • As shown above, the mix of the marital status among the respondent groups are slightly different. a The RN sample group, 71.9% are married while 84.6% of the RN student group and 31.62 of the generic nursing students are married. 21. Number of dependents of the respondents: RN Sample Group it None 111 One 45 44 Two Three 16 Four 5 Five or More __ 2 To tal Responses RNs at SVSC # % 9 ( 49.8) 1 ( 20.2) ( 19.7) 14 2 ( 7.2) 2.2) 2 ( _0 0.9) ( 223 (100.0) % All RNs it ( 32.2) 120 46 ( 3.6) ( 50.0) 58 ( 7.1) 18 7 ( 7.1) ( 0.0) __ 2 28 (100.0) Nursing Students 251 ( 47.8) 78 7 ( 18.3) 8 ( 23.1) 2 ( 7.2) 2.8) 0 ( 0.8) _0 ( (100.0) % it % it ( 82.1) 198 ( 7.4) 53 ( 8.4) 66 ( 2.1) 20 ( 0.0) 7 ( 0.0) __ 2 95 (100.0) • As evident from the above chart, nearly 50% of the RN sample group have no dependents. This rate is similar with all RNs surveyed (47.8%) as well as with the RN SN composite group (57.2%). Ill RN SN Survey Composite 346 % ( 57.2) ( 15.3) ( 19.1) ( 5.8) ( 2.0) ( 0.6) (100.0) • The modal categories for the RN student group and nursing student group, however differ greatly. Only 32.2% of the RN stu­ dent group have no dependents, while 82.1% of the generic nursing students have no dependents■ 22. Ages of the respondents' dependent: The mean dependent's age for each of the respondents who have one or more dependents were calculated. The mean dependent's age for all the survey respondents were found to be 7.7 years old with a standard deviation of 5.5. The dependent's age ranged from less than one year old to 19 years old. The above section described the respondents' Interests In the proposed program and the demographic characteristics for both RN respondents and nursing student respondents. The following section deals with questions geared only toward the generic nursing students. 112 RESULTS OF THg QUESTIONS THAT OHLY APPLY TO THE GENERIC NURS­ ING STUDENTS This section relates to the Nursing Student Survey ques­ tions #1 through #3 and #12 through #15. These questions deal with the respondents" plans to continue their education. 1. After you graduate from SVSC, do you plan to continue your education through a formal academic institution? Number of Res ponses Yes No Maybe 80 ( 83.3%) 14 ( 14.6%) _ 2 ( 2.1%) Total Responses 96 (100.0%) • As shown above more than 80% of the nurs­ ing students Intend to continue their education through a formal academic insti­ tution. 2. If the answer for #1 is yes, what type of academic pro­ gram and field of Btudy would you choose? Number of Response s MSN or MS with major in nursing Master's degree with field not specified BS or BA in psychology MBA BS in biology Anesthesia General indirect courses 72 ( 87.9%) 4 ( 4.9%) 2 1 1 1 1 2.4%) 1.2%) 1.2%) 1.2%) 1.2%) ( ( ( ( ( 82 ( 100.0%) 113 • As shown in the above chart, of the 82 respondents who expressed Interest in continuing education through a formal academic program, 8 7.9% of them responded that they intend to choose a MSN or MS program with a major in nursing. 3. How soon would you like to begin the above educational plan? Number of Responses ( 6 .0 %) 34.9%) 25.3%) 20.5%) 13.3%) Immediately after graduation Within 1-2 years Within 2-3 years Within 3-4 years After 5 years or more 21 Total Responses 83 (100.0%) 5 29 17 11 ( ( ( ( • Of 83 respondents, 29 of them (34.9%) responded that they would begin the above plan within 1-2 years. • Another 25.3% reported that they would begin within 2-3 years. • Another 20.5% responded begin within 3-4 years. that they would • Only 13.3% reported that they would start after 5 years or later. 12. If you answer for #5 is "no, but I plan to enroll in other MSN program," what would be the reason not to choose the SVSC program? (Check all that apply) The question #5 asked the following question: #5. If the MSN rogram is established at SVSC within the next 2-3 years, will you plan to enroll in the program? A. B. C. D. Yes, definitely Yes, maybe No, but I plan to enroll in another MSN program No, I do not plan to enroll within next 5 years 114 Number of Responses The proposed program may not be accredited for a while Not sure of the proposed program SVSC will be outside commuting distance Insufficient number of qualified faculty Do not meet qualifications required Not sure 10 ( 3 7 . IX) 9 ( 33.3%) 5 ( 18.5%) * I ( 3.7%) 1 ( 3.7%) 1 ( 3.7%) 27 Total Responses (100.0%) • Note that 19 of 27 (70.4%) who choose not to go to the proposed program falls Into the first two categories deal with the unknown quality of the proposed program. 13. If your answers to #5 is "No, I do not plan to enroll in the next 5 years, "what would be the reason(s) not to do so? (Choose as many as apply) Number of Res ponses Prefer to delay education till my children grow up No child care facility or person to care for children Prefer to gain at least 3-5 years of experience after graduation Prefer to wait until the proposed program is established Other 3 ( 14.3%) 15 ( 71.4%) Total Responses 21 0 ( 0.0%) 3 ( 14.3%) 0 ( 0.0%) (100.0%) • It is evident in the above chart that 71.4% of the respondents prefer to gain at least 3-5 years experience before they go on for a MSN degree. • Of the 21 who responded, 3 (14.331) prefer to wait till the children grow up. 115 • Another 3 out of 21 (14.32) prefer to wait until the SVSC program Is established. 14. What is your current level in the SVSC BSN program? Number of Res ponses Sophomore Junior 1 Junior 2 Senior 1 Senior 2 22 16 22 17 18 Total Responses 95 (100.OX) ( ( ( ( ( 2 3.2X) 16.82) 23.22) 17.92) 18.92) • The chart above shows the number of respondents for each class level within the SVSC BSN program. • The difference in the are due to the varied size due to attrition student's decision to to participate in the 13. number of responses number of class and also to the participate or not survey. After graduation, where do you plan to be employed? Number of Res ponse s Agencies within 50 miles of SVSC Agencies beyond 50 miles, but within the State of Michigan Agencies outside the State of Michigan Unsure Unsure, but would stay in the State of Michigan 60 ( 64.52) 23 ( 24.72) 5 ( 5.42) .4 ( 1 ( 4.32) 1.12) 93 (100.02) Total Responses • It is evident from the above chart that 64.52 of the respondents would be employed within 50 miles of SVSC. 116 SUMMARY OF THE RESULTS OF THE REGISTERED NURSE AND NURSING STUDENT SURVEYS This section has reported the results of the Registered Nurse Survey and the Nursing Student Survey. Because there were some common items between the two surveys( these two surveys were reported together. Items unique to each survey group were ^reported separately. Each question was answered, taking into account, each subgroup of the surveys, registered nurse sample group, the nursing student group. SVSC RN student group, the and The composite data for both RN and nursing student surveys were also reported tive purposes. i.e., for descrip­ Characteristics of the registered nurse respondents and the nursing student respondents were identi­ fied. Their Interests in the proposed MSN program, clinical specialties, types of and functional roles were identified. The respondents'' Intent to complete the MSN requirements, e.g., full- or part-time enrollment, preferred semesters, and days of the week, have also been identified. A number of valuable comments written by the respondents were found on the questionnaires. S. These are included in Appendix R and These data will be analyzed in Chapter V after closely examining the potential employer survey data as well as the data obtained through task force groups, tors . 117 and social indica­ THE RESULTS OF TEE POTENTIAL EMPLOYER SURVEY This section reports the results of the Potential Employer Survey. Of the 61 questionnaires sent to the sample health care agencies, 35 (57.4%) were returned. The following chart presents the number of agencies who responded to the survey according to the type of health care agency. (This chart applies to the Potential Employer Sur­ vey question It 15.) Number of Resondents Type of Agency Acute care hospital (bed capcity less than 150) Acute care hospital (bed capacity over 150) Long-term care facility VNA or community health agency Psychiatric/mental health facility Home care agency Indust ry Rehabilitation hospital Community college 10 (28.6%) 7 (20.0%) 6 6 2 1 1 1 1 (17.1%) (17.1%) ( 5.7%) ( 2.9%) ( 2.9%) ( 2.9%) ( 2.9%) 35 (99.9%)* *Rounding error. Highlights from the above chart, Include: • Seventeen of the 35 (48.6%) who responded were from acute care hospitals. • Six agencies responded from each of the long-term care facilities and VNA/coramunity health agencies. • A total of two psychiatric/mental health facilities responded. • A single organization completed the ques­ tionnaire for a home care agency, indus­ try, rehabilitation hospital, and commun­ ity college. 118 The following section reports the results of each ques­ tion in this survey. 1. How many RNs are employed in your agency? Humber of RNs A sum of all full-time RNs A sum of all part-time RNs 1,900 1,250 • Of 35 agencies which returned the question­ naire, all but one agency answered this question. 2. What is the number of RNs having the following educa­ tional preparation as their highest? Sum of Number Reported for Bach Category Diploma ADN BSN Bachelor in other field Master in nursing Master in other field PhD or DNSc 585 776 312 33 53 10 0 C .33.1%) ( 43.9%) ( 17.6%) C 1.9%) ( 3.0%) C 0.5%) ( 0.0%) 1,769 (100.0%) Number of Agencies • The above chart shows the number of RNs employed in the respondent agencies, categorized by their educational ba c k ­ ground . • The number shown on the far right indi­ cates the number of agencies which responded to this question. • Because a large number of respondents did not answer this question, generalizability of this result must be made with caution• 119 31 30 28 19 13 7 5 3. How many of your RNs are currently enrolled In a BSN program? The number enrolled: 73 in BSN programs • A sum of 73 RNs from 26 agencies that responded to this question are currently enrolled In BSN programs. • Again, because 9 out of 35 (25.7X)respondents left this Item blank, the number represented should be Interpreted with caution. Which of the following positions does your agency require or prefer a MSN background? (Check all that apply) Number of Agencies Required Vice President, Nursing Director of Nursing Assistant Director of Nursing Director of Nursing Education, Hospital Education or Staff Development Coordinator, Nursing Research Clinical Nurse Specialist Coordinator/Manager/Supervisor, Patient Care Head Nurse Charge/Primary Nurse Community College Faculty MSN not required not preferred for any of the nursing posi­ tions Preferred 7 11 2 4 1 9 6 7 •0 0 0 0 1 0 6 3 2 7 0 0 0 0 0 0 0 4 2 1 0 The highlights from the above chart include: • Of the 35 agencies who returned the ques­ tionnaire, all but one agency answered this question. • Of the eight agencies that have a position of Vice President of Nursing, seven agen­ cies require a MSN degree for the position. 120 Not Preferred or Required vO O O O 4. • Eleven agencies require a MSN background for the Director of Nursing position, nine agencies prefer a MSN background. • Four agencies require a MSN degree for the Director of Nursing education position, seven agencies prefer a MSN prepared nurse. • Six agencies responded that they require a MSN degree for their clinical nurse spec­ ialist position, while two agencies prefer MSN prepared nurses for the position. • Three agencies responded that they require a MSN prepared nurse for the coordinator position while seven others reported that a MSN background is preferred. • There was no agency that required a MSN background for the head nurses' position while four agencies reported that they would prefer the background. • Two agencies reported that a MSN background is preferred for a charge or primary nurse position. • One community college reported that they would prefer a MSN background for the faculty positions. • Nine of the 35 agencies reported that they would neither require nor prefer a MSN background for any of the nursing posi­ tions . 5. If a MSN is required or preferred for any of the nursing positions, please check whether or not those positions vacant. If vacant, please indicate the number of vacan­ cies . Vice Presient, Nursing Director of Nursing Assistant Director of Nursing Director of Nursing Education, Hospital Education or Staff Development Clinical Nurse Specialist 121 No vacancy 3 vacancies No vacancy 2 vacancies (one at cor­ porate level in home care agency) 4 vacancies (one as pedi­ atric nurse practitioner) 2 vacancies (as quality assurance coordinator, corporate level home care agency) 1 vacancy 1 vacancy Coordinator/Manager/ Supervisor, Patient Care Head Nurse Charge/Primary Nurse • Fifteen of the 35 agencies did not respond to this question. • Some vacancies are noted across various nursing positions as shown above. 6. If a MSN is not required for any of the current posi­ tions, is there any plan to recruit a MSN prepared nurse, provided any vacancy occurs in the near future in the positions listed in question #4. (Check, one) The following chart shows the response patterns of various agencies for this question. Number of Agencies Responded as "YES, Will Recruit MSN Prepared Nurse" Acute care hospital with bed capacity over 150 Acute care hospital with bed capacity under 150 VNA/community health agencle s Home care agencies Psychiatric/mental health facilities Rehabilitation hos­ pital Long-term care facility Community college Industry Total 122 "NO, Will Not Recruit MSN Prepared Nurse" 1 2 2 0 1 0 I 7 1 0 0 1 12 19 The highlights for the above chart Include: • Of 35 respondents, 12 ( 3 4 .3%)reported that they would recruit a MSN prepared nurse for the positions listed in ques­ tion #4. Nineteen (54.3%) agencies reported "No". • Of 35 respondents for this survey, four have been left blank for this question. • Those agencies which reported that they would recruit a MSN prepared nurse are acute care hospitals with a bed capacity over 150, VNAs (Visiting Nurses' Associ­ ation) or community health agencies, and psychlatrlc/mental health facilities. • Those which reported that they would not employ a MSN prepared nurse were pre­ dominantly long-term care facilities and small rural hospitals. 7. Which' of the following positions can a BSN with a mas­ ter's degree in another field (other than nursing) satisfy the qualifications in your agency? (Check as many as apply) The following chart shows the number of agencies who answered that a BSN with master's degree in another field would satisfy each position listed. Number of Vice President, Nursing Director of Nursing Assistant Director of Nursing Director of Nursing Education/ Staff Development/Hospital Education Coordinator/Manager/Supervisor, Patient Care Head Nurse Charge Nurse/Primary Nurse Faculty, Community College Blank encies 6 14 8 18 6 4 5 1 11 • Note that six agencies reported that the vice president of nursing position can be filled with BSN with a master's degree in other field. 123 • Another 14 agencies reported that the director of nursing position can be satis­ fied by this category. • Other positions a BSN with master's degree in other field can be satisfied Include, a director of .nursing education, an assis­ tant director of nursing, a coordinator or manager in nursing, a head nurse, and a charge nurse. • One community college reported that a BSN with master's degree in other field would satisfy its faculty position. 8. Which clinical specialty for MSNs would meet the needs of your agency? (Check as many as apply) Number of Agency Responses Adult-medical surgical Ge rontological Community health/home care Pedlatrlc/chlld health Psychiatric/mental health Health care for women Administration Industrial/occupational health 17 14 13 11 10 5 3 1 • As shown above, adult medical-surgical specialty is the area in need the most. • Gerontological specialty was rated as the second most needed area In this survey. • The community health nursing including home health care are next in demand. • Note that parent-child health, psychia­ tric/mental health and health care of women follow after community health nursing. • Administration and industrial health are rated as the last two prioritized spec­ ialties. 124 9* If you plan to employ MSN graduates, roles will be needed? what functional Number of Respondents Nursing administrators Clinical nurse specialist Nurse educator Nurse researcher Quality assurance coordi­ nator Program d i r e c t o r ’ 18 15 12 5 I 1 • As shown above, the nurse administrator role is needed by the agencies the most (18 out of 35 possible responses)* • The clinical nurse specialist role is next in demand (15 out of 35 possible r espon s e s ) * • The nurse educator is the third role needed by the agencies (12 out of 35 possible responses). • Note that five agencies are asking for nurse researcher's roles. • Quality assurance director and program director role each received one response. 10. If the proposed program were to provide a major in nursing administration, which of the following topics are important in your agency? Please rank the follow­ ing topics according to the importance in your agency. (1 being the most important, 2 being the second most important, etc.) The following chart shows a mean rank score for each of the ten items and the ranking order of the mean rank scores. 125 Mean Rank Scores A. B. C. D. E. F. G. H. I. J. Management information systems Health care financing and management Personnel management Legal aspects of health care Nursing leadership Labor relations Marketing Entrepreneurship Long-term care adminis­ tration Research Overall Rank 4.36 4 3.86 3 2.97 4.79 2 3 2.17 6.30 3.81 7.24 7.27 1 7 6 8 9 8.83 10 • As noted above nursing leadership was rated as the most Important Item by the respond­ ents . • Personnel m a n a g e m e n t , health care financing and management are rated as second and third most Important itemB respectively. • Management Information systems, legal aspects of health care and marketing are ranked following the above Items. • Labor relations and entrepreneurship are ranked seventh and eighth. • Long-term care administration and research are the last in priorities. 11. If your employee decided to go on for a MSN degree, would you be willing to provide any of the following support? (Check as many as apply) Number of Responses 21 1 24 21 1 Total Responses 68 *Rounding error. 126 ( 3 0.92) ( 1.52) ( 35.32) ( 30.92) 1.52) ( •s N ed • o o Tuition reimbursement Scholarships Accommodate work schedules Leave of absence None • The above chare shows the types of support provided by the agencies if their employees plan to earn a MSN degree. • Accommodation of work schedule was the most frequently mentioned support (24 out of 68 responses, 35.3%). • Other support Include tuition reimbursement (30.9%) and leave of absence (30.9%). • One agency reported that they would offer scholarship assistance. • One agency responded that no support would be provided. • It is evident from the above information that nearly two-thirds of the agencies responded would offer some type of support to their employees who plan to pursue m a s ­ ter's education. 12. If your employee earns a MSN degree while employed in your agency, what type of Incentives would be provided by the agency? Number of Responses Job reassignment tos u i t ’ educational background Promotion to ahigher position Pay raise None Unknown 18 13 9 9 1 • The above chart shows the type of incen­ tives agencies would provide if an employee earns a MSN degree. • The category job reassignment to suit the educational background of the employee was the most frequently selected response (18 out of 35 possible responses). • Promotion to a higher position had 13 out of 35 possible responses. 127 • Nine of the 35 agencies Indicated a pay ralBe as a means of incentive and nine responded that they will offer no incen­ tive. 13. If- SVSC begins a MSN program, what type of resources would be available in your agency to help support such a program? (Check as many as apply) The following chart lists the types of resources ava i l ­ able by the agencies to support the proposed MSN pro­ gram. Number of Responses Clinical sites Potential students Arena for research activities Future employment opportuulties Preceptors 19 17 15 13 11 • It is evident from the above data that several types of resources are available at the agency level to support the pro­ posed program. e Clinical sites was by far the most fre­ quently mentioned resources that the agencies would offer. • The agencies saw their employees as a potential source of MSN students. • Arena for research activities were also chosen by 15 respondents. • Thirteen agencies listed future employment opportunities as resources. • Eleven agencies mentioned preceptor arrangement possibilities. 128 14. Would your agency be willing to employ the graduates of the proposed MSN program? (Check one) Number of Responses 26 ( 74.3%) 4 ( 11.4%) 5 < 14.3%) Yes No Blank 35 (100.0%) • As noted above 26 of the 35 (74.3%) respondents reported that they would employ the graduates of the proposed MSN program. • Four (11.4%) reported that they would not employ the graduates of the proposed program. • Five agencies left the question blank. • The agencies which reported that they would not employ the graduates from the proposed program were primarily long-term care agencies. The Appendix T lists the respondents comments added to the questionnaire. 129 SUMMARY OF THE POTENTIAL EMPLOYER SURVEY The responses Co each question of the Potential Employer Survey were summarized and reported. It was e v i ­ dent that employers of area health care agencies are Interested in the proposed MSN program. provide support and resources. They are willing to The areas of specialty and functional role that meet the employer needs were identi­ fied. Some of the vacant positions that calls for MSN pre­ pared nurses were identified. the survey results. This concludes the section of The following section describes social indicator method of collecting data for the feasibility study. 130 the RESULTS OP THB TASK FORCE GROUPS: This section describes the outcome of each of the Task Force Groups. The Task Force Meetings took place between December 5, 1985 and February 12. COMMOMITY TASK. FORCE GROOP: 1986. SESSION I {December 5. 1985) In spite of adverse weather conditions. 11 of the 13 members representing various constituent groups were able to attend. In general, proposed MSN program. the members were favorable towards the They contributed a number of concerns and ideas during the session. During the two hour meeting, the following needs and resources were identified by the members of this group through the nominal group process. The Needs During the first half of the meeting, a total of 13 items related to the types of expertise needed In the area health care system were identified. The members then ranked the items in the order of priority (e.g.. item. 1 the most needed 10 the least). The next area shows the various roles and competencies of master prepared nurses identified as needed in the area. These are listed according to the established priorities. The sum of points highest (each member provided 10 points to the rank and 1 point to the lowest) are also shown for each item. 131 N eeds Rank Id e n tifie d by th e M e m b e rs : Points 1 65 A. Service coordinator - administration In hospital and community, administration in geriatrics. 2 57 B. Strong business skills Included In curriculum - Joint degree specialist or - Minor In business for nursing/ health care. 2 57 C. Clinical Specialist - Cardiovascular - Oncology/Hospice - Med/Surg - Ob/GYN/Peds (in depth) - Independent practice - Technology experts 4 50 D. Access to MSN programs for working nurses In the area. 5 4 6 40 F. Instructors 7 28 G. Coordinator with other disciplines. 8 27 H. Instructors in hospitals. 9 26 I. Health maintenance and wellness programs for elderly. 10 23 11 19 K. Supervisory positions in home care. 12 17 L. Program development/planning. 12 17 M. D.R.G. and insurance expertise. i 4 E . Coordination for nursing research - Hospital - Community. J. for ADN & BSN programs. Entrepreneur - generation of service to meet needs of the community. 132 Highlights of the above needs indentifled by this group include: • The item ranked as the highest priority is the need for nursing service coordinators with expertise in administration. This type of expertise Is needed at all levels of health care. Strengthening administra­ tive background of those who specialize in geriatrics was also identified as a need. e The members all agreed that strong business skills are urgently needed by the nurse administrators today. This item was tied as the second in priority. The members recommended that this type of background can best be attained through the MSN program in collaboration with the school of business by way of a minor or a joint degree. • Clinical nurse specialists is tied as the second priority. This type of expertise is needed in all specialty areas. The members expressed that the area health care system can be benefited by the knowledge and exper­ tise of the master-prepared registered nurse in cardiovascular, oncology. Hospice, adult medical, surgical, and maternal child health specialty areas. MSN prepared "Technology" experts also were identified as needed, in order to be prepared for continually expand­ ing "High Tech" in clinical nursing. • Better access to MSN programs for working nurses in the area is ranked as third in priority. Easy access to MSN programs is needed in the Saginaw area to have the first 3 types of MSN prepared nurses as identified above. • Expertise is needed to coordinate nursing research activities in the area health care agencies* This item was prioritized as the fourth item. 133 • Instructors for both ADN and BSN programs are constantly In demand. This Item was prioritized as the fifth item. • Several other areas of expertise listed include: Coordinators with other disci­ plines, nursing instructors in hospitals, health maintenance and wellness program experts for the elderly. • Entrepreneurs for generating nursing service to meet the health needs of the the community is rated as the tenth priority. This expertise calls for more creativity within the nursing role and to be Innovative in the ways nurses can better serve the community. e Other kinds of expertise listed by the members but not entered within the top ten ranking Include: Home care supervisor, program coordinator, DRG and Insurance expertise. Resources During the second half of the meeting, the members focused on the identification of resources available in the area health care agencies to support the proposed program. Eleven items were identified. ensued. The ranking of the top ten The following shows the listing of a variety of resources, points assigned by the member (using the same method as above), and the ranking: 134 R e s o u rc e s Id e n tifie d Rank PoInts by A* th e M e m b e rs : 1 64 Preceptorshlp In Nursing Administration - VNA - Home care - Hospitals. 2 51 B. Employment in: - Home care - Community health care. 3 50 C. Hands-on clinical experience assessment at clinics (Saginaw County Health Department). 4 45 D. Arena for research activities and support dollars. 5 44 E. Staff for preceptorshlp on hospital Staff & MD's offices (Saginaw Cooperative Hospitals Inc.). 6 39 F. Financial Assistance and time for studies (also VA scholarships for MSN students). 7 33 G. Mental Health - geriatric consul­ tation (Federal dollars available). 8 31 H. Position available for training geriatric health care team (Area Health Education Center). 9 30 I. Position for Administration in community health. 10 27 J". VA outreach clinic has position for a nurse prepared at MSN level. 11 8 K. Potential students 135 (VNA). The highlights of the above resources identified by this group include: • Preceptorshlp in nursing administration is ranked as the highest of all other resources listed. For example, the preceptorshlp arrangements will be available at Visiting Nurses Associations, home care agencies, and hospitals. • Employment opportunities are the resources ranked as the second priority. These posi­ tions will be available especially in the home care agencies and the community health agencies. • Also available are the agencies for clinical placement of the students. For example, opportunities for hands-on experience in the area of assessment are available in clinics at Saginaw County Health Department. This item is ranked aB the third priority. • Availability of an arena for nursing research activities and support dollars is ranked as the fourth priority. e The next in rank is the availability of staff from Saginaw Cooperative Hospitals, Inc., as preceptors at hospitals and at the physician's offices. (This was mentioned by a physician, whether or not this would be appropriate background as a preceptor for the MSN students is in doubt. However, the researchers Interpret this as the opportunities for coordination and collaboration between nursing and medicine within the community). • Financial Assistance and arrangement of time for graduate studies is ranked as the sixth resource item in priority. Also mentioned are VA scholarships available to MSN students. 136 • Federal dollars are available Co encourage graduate studies In mental health and geriatric specialty, and to Increase the number of experts In these specialties. • The next Item mentioned Is a position available for MSN graduates for training geriatric health care team. This Infor­ mation was provided by the staff from the Area Health Education Center. • The next item Identified Is the Immediate and future positions In nursing administra­ tion available at community health agencies. • Another position Is available for MSN pre­ pared nurses to work at a VA outreach clinic in the underserved area (tenth in rank). • The item not Included within the top ten resources but considered as a type of resource Is the availability of potential students for the proposed MSN program. 137 COMMUNITY TASK FORCE CROOP; SESSION II (January 2. 1986) Two additional members who were unable to attend the first session attended this session. member of SVSC, One member, who Is a faculty indicated It would be more appropriate for her to be a member of the SVSC College-Wide Task Force Croup. Therefore, she did not attend the second meeting. The major questions addressed during this session were: 1. What may be the potential barriers to the development of the proposed MSN program? 2. What types of planning would be necessary In order to plan a success­ ful MSN program? The ideas, concerns, and opinions expressed relative to the above two questions are listed as follows. are not ranked or placed in priority order. 138 These items 1 . 2 . Where and how will qualified faculty be recruited? - Faculty with Ph.D. - Possible use of part-time faculty off season. What is the availability of qualified preceptors in the area? - Academic - Experiential. 3. What are the funding sources? - Grant application from HHS - Need supported. 4. Will this be a full or part-time program? - Will part-time program be funded? - Cost effective? 5. Will a thesis or research project be required for graduation? 6 . What will be the areas of specialty? - Administration - Business. 7. What are the sources of potential students: - Include unemployed nurses - Industrial nurses. a. Is it possible to offer a combined BSN and MSN? 9. What are the opportunities for collabor­ ative research with: - MBA program - Physicians - Industry - Occupational health group. 10 . 11 . 12 . Are the facilities adequate? SVSC - Offices - Classrooms - Research facilities - Library resources. What are the clinical facilities? - Non-competitive time and spaces. What are the funds for students? - Scholarships - Other? 139 13. Are physicians potential employers or competitors? 14. What are the market needs? - Price people out of a job? 15. What are realistic job potentials? 16. What are the sources of encouragement/ support to potential MSN students? 17. What are cost effectiveness potentials? 18. Is there a need for upgrading the existing system? 19. How will competencies of MSN be articulated? 20. Is there a need for MSNs in nontradltional settings? - use of forecasting. 21. How* do needs change over time? 22. What marketing strategies will be used for the MSN program? 23. What will be the admission criteria? - Deficits to be corrected? 24. Will the GRE be required? 25. Are the goals of the faculty in conson­ ance with potential students? 26. In the selection process ask potential students re: - future employment - future goals. 27. What are the advancement opportunities in an organization? 28. Will advanced preparation Impact reim­ bursement? The topics of discussion during the session can 'be classified into four main areas: (1) resources, manner in which the proposed program is offered, determining market needs, and (4) opportunities 140 (2) the (3) for the graduates. The summary of the discussion of these four areas ensues. Resources Heeded for the Proposed Program: Monetary resources, areas were addressed. facilities, faculty and clinical One of the areas the group was con­ cerned about was the source of funding, e . g . , whether or not a grant will be obtained and to what extent the college Is committed to provide continued financial support for the continuation of the program, and whether or not the proposed program would be cost effective was another concern raised by this group. Whether or not the college has appropriate hinds and number of facilities to support the proposed graduate pro­ gram was another area of concern* vide office spaces, classrooms, The college should pro­ research facilities, and library resources for the proposed program. Where and how the college will recruit qualified, Ph.D.- prepared faculty, was an area of primary concern by the group. Providing competitive salaries and recruiting part-time faculty from other colleges during summer months were some of the ideas generated by this group for recruit­ ment of qualified faculty. Another area addressed was availability of adequate clinical facilities and qualified preceptors. Although obtaining clinical sites may not be a major problem, recruit­ ment of experienced preceptors who have appropriate academic background may take some effort. 141 The Manner In Which The Program Will Be Offered: The group members were curious as to how the program would be provided. Whether the program will accept part- students or limit Its admission to full-time students; whether a thesis or field research will be required; whether GRE Is to be taken prior to application. and Another area discussed was how the areas of specialty and functional role would be determined. The program also needs to deter­ mine what MSN graduates can really do. Determining the Market Heeds: What are the market needs? time? How will needs change over These were two questions posed for discussion. The program must be geared toward the type of nursing service needed within the next few years, as well as, the changing needs of the people In the area. toward meeting The program also must plan to assess the sources of potential students and their learning needs. Impact of recent changes in economic status of the health care agencies must also be taken into account. Some expressed concern about future employment opportunities and questions as to whether or not MSN degree holders would price themselves out of positions. funds for students should also be considered. Sources of What other type of support is available to the potential students? will be the Incentives What for them to go on with graduate studies? What are some of the ways to market 142 the proposed program? Although the session ended with more questions than answers, this session provided the researchers with a number of areas to be considered with as the feasibility study continued. The group members actively participated in the discussion and concluded the session with the request that they continue to be informed about both the status of the feasibility study and the planning of the program. This section reported the outcome of the Community Task Force Group. The next section reports the outcomes of the SVSC Nursing Alumni Task Force Group. 143 SVSC NORSIHC ALUHHI TASK FORCE Seven members of the SVSC Nursing Alumni Association attended the January 28th meeting. As the members were contacted by the researcher by phone, the alumni members expressed much interest in the proposed program. The members who attended this meeting were from a variety of health care agencies and various positions within the agencies. One mem-* ber was a director of a nursing service in a medium sized hospital, agency. another member was a supervisor of a home care Other members included head nurses and nursing supervisors of acute care hositals and staff nurses. One member was about to complete a masters degree in Nursing. Using the Nominal Group Process, the members addressed the fqllowirig two questions: A. What would motivate you to enroll in a MSN program if developed at SVSC? B. What would be the barriers for you to enroll in a MSN program If developed at SVSC? In a relatively brief time the group identified important items for ranking. assign points The members were asked to to the five most Important items, to the most Important, five (5 points and 1 point to the fifth item in importance). 144 The following lists the responses of the members each of the above questions. for The responses are listed In the order of priority as Identified by the members. The Motivators: Rank Points Motivators 23 Type - of specialty offered: Medical-Surgical Parent-Child Community Health Psychiatric Administration. 21 Pursue an advanced role/ Job advancement in Tri-City Area: - Administration - Education - Clinical Specialist. 3 18 Part-time program for working nurses. 4 11 Proximity. 5 9 Number of credit hours required for graduation - 45 vs. 60. 6 6 Tuition lower than others. 7 5 Better employment opportunities - Practicura experience as a stimulus to future jobs. Personal committment education. to higher 8 2 Hark experience count as clinical (7). 8 2 Reputation of the BSN program. 145 Other responses not identified among the top five prior­ ities by the members were: a. Financial assistance to be made available to the MSN students, b. Employer support/schedule adjustment, c. Availability of faculty to students, and d. Likely to attain NLN accreditation. The highlights of the motivators identified by the alumni members were as follows: • What motivates potential students the most would be if the specialty of choice is offered at SVSC. The areas of specialty the members identified Include: medicalsurgical, parent-child, community health, psychiatric, and administration. • Upon earning the MSN degree they could pursue an advanced role within the Tri-City area. These roles were identified as: administrator, educator, and clinical s pecia li st . • The program would likely be geared toward part-time students in the area health care agencies . • Proximity is Important for those who have family and work responsibilities in the college service area. • A number of credit hours are not excessive. Forty-five credits are tentatively planned for the proposed program, which appeals to them and would be more attractive than a pro­ gram which require sixty credits. • The tuition at SVSC is lower than other graduate programs in Michigan. 146 • An MSN degree would provide Chen with better employment opportunities. The practlcum experience provided In the MSN program may become a stimulus to the attain­ ment of future jobs. • The program would appeal to them if their experiential backgrounds were counted as a part of clinical. (This is a desire of the member and was not presented as a part of the proposed program.) • The BSN program is reputable in the area and the MSN program would likely be accre­ dited. • Other motivators mentioned but not entered into the top ten ranking of motivators Include: financial assistance and employer support by way of work schedule accommoda­ tions and other in centives. Availability of the faculty to students was mentioned as another factor that would motivate the stu­ dent bo choose a MSN program. Among the barriers to a MSN program were the following: The Barri er s; Rank Points Ba rrlers 1 30 Demand to take a full load each term Time factor Cost factor. 2 19 Conflict with work schedule 3 16 Limited program focus - Maj o r - Emphasis. 4 U Travel to outside Saginaw area - Resist travel over 40 miles. 5 10 Thesis requirement. 6 7 Pre-requirements - Non-NLN accredited program graduates? 147 Rank Po inta Barriers 7 6 Practicuo experience at competitor agen cy . 8 1 Conflict with family 8 1 Transfer credits from MBA? Other responses identified but, not listed as the top five priorities Included: a. Nursing research required as partial requirement, b. Parking availability, and c. Library resource accessibility on weekends• The highlights of the above barriers as identified by the member of the Alumni Task Force Group Included: '• The demand to take a full load each semester would be a barrier to pursuing a MSN degree In terms of both cost and time. It would be Impossible to main­ tain a full-time position as a registered nurse and still engage in full-time grad­ ate studies. • A limited program focus which did not match with individual preference would be another barrier to choosing the SVSC pro­ gram. If one chose the SVSC program depends on what type of specialty and functional role the program concentrates. • Having to travel outside the Tri-City area to commute to Bchool would defi n­ itely be a barrier for the choice of the graduate program. Some members stated that they "RESIST" driving over AO miles (one way)I • Prerequisite and thesis requirements would be other barriers. The respondent would prefer that an alternative to these requirements be considered. 148 • Other barriers mentioned by this group Include: practicum experience at c o m ­ petitor agency, conflict with family and conflict with family responsibilities. • One member asked whether or not the credits toward his MBA would count toward the MSN degree. This section described which the outcome of the discussion took place at the SVSC Alumni Task Force Group. The following section reports the outcome of the SVSC Nursing Faculty Task Force Meetings. SVSC HORSING FACULTY TASK FORCE CROPP The Nursing faculty group met twice, February 12th), MSN program. (January 15th and examining the feasibility of the proposed All available faculty members of the depart­ ment participated in the discussions hours each meeting. for approximately two This group focused its discussions based on the following two questions: 1. What academic considerations should be addressed related to the develop­ ment of a graduate Nursing Program at SVSC? 2. What administrative and financial plans do you think we should address? The reports from each of the two sessions follows. 150 Session I (January 15th for 1 1/2 hours) During the Session I, the faculty addressed the first question as stated above. The following iterns/questions were identified as areas of academic considerations in relation to the development of a graduate nursing program at SVSC. Group Process was used to Identify the items. The Nominal They are ordered according to the greatest weight assigned by the faculty. Rank 1 Po ints 42 Academic Considerations Adequate number and preparation of the faculty. - Will the faculty come from the current 14 positions or from outside? - Match of faculty expertise with the focus of the program. 37 Maintain accreditation for the B5N program - Timing of the development of a MSN program? - What will happen to the cur­ rent "RN to BSN" program? 3 32 Organizational plan for the curricu­ lum. 4 31 Possibility of testing academic policies and requirements before implementation - Thesis vs. other requirements for graduation. - Congruency of college and department policies. - Admission criteria (prerequi­ site. BSN or BS/BA from other field?) - Size of the program, part-time or full-time offering? 151 Rank 5 Points 30 Academic Considerations Potential students. - Characteristics - Needs 6 29 Program focus congruent with college mission. Research vs. 7 21 teaching focus? Appropriate learning resources. - Library - Clinical facilities, - Preceptors. and 8 13 Content area of concentration. 9 12 Market for potential students. - Similar programs exist in the area? 9 12 The presence of a MSN program would increase the number of qualified faculty in both BSN and MSN programs, - Facilitate recruitment 11 11 Sufficient number and quality of cognate courses at SVSC (graduate l e ve l ) . The highlights of the group's concerns, interests, questions include: The greatest concern the Faculty of the Department of Nursing had regarding the proposed program is to what extent the faculty of the BSN program would become Involved with the proposed MSN program. The faculty expressed concerns toward their lack of time and expertise to accommodate a new program at a graduate level. They asked for clarification regarding the organizational structure if a proposed program is to be included in the department. Their question is whether or not new faculty members with a Ph.D. would be recruited. If so, how many? 152 and • Another concern expressed by the faculty members Is the timing of the develop­ ment of a MSN program. The current faculty members felt that maintaining the accreditation status of the BSN program is a priority over the proposed program. They also questioned what would happen to the RN and BSN program when a MSN program begins. • If a new program Is to be developed, a structured plan should take place for the development of the curriculum. • Academic policies and requirements should be developed and tested prior to more permanent implementation. The areas of special concern Included: -- Whether or not a thesis is required for graduation. -- How to deal with meeting both departmental and college policies. -- What are the admission criteria? — What is the projected MSN enroll­ ment? -- Will the program be full- or partt ime? • Another area of concern raised by the faculty is how to identify the character­ istics and learning needs of the poten­ tial students. • There is concern for the possibility that the program focus may not be congruent with the college's mission. • The students of the proposed program should be provided with appropriate learning resources and adequate facil­ ities. This includes: library hold­ ings for graduate level studies,clinical facilities, and qualified preceptors . 153 • Content areas of concentration should be determined according to the needs of the constituent groups. • What Is the market size of the poten­ tial students? Do similar programs exist in the area? e The presence of a MSN program would attract faculty with Ph.Ds., which In turn would benefit both MSN and BSN programs. • Availability, quality, and quantity of cognate courses should be Identi­ fied through collaboration with other graduate programs within SVSC. Session IX (February 12. 1986 for 1 1/2 homra) At the second meeting the group focused the discussions on administratively related areas of concerns for the pro­ posed MSN program. The nominal group process was again used. The following described the result of the meeting. Rank 1 Points Areas of Concern 18 Adequate support: - 2 17 Budgetary Staff Library Advising Computer facility Student facility Organizational Structure. - Structure of the department, - Responsibility of the chair­ person, and - Program organization. 3 17 Administration's commitment to to recruitment and retention of faculty. 4 11 Informing other departments about the- program as well as receiving their input. 154 Rank Points Areas of Concern 5 7 Research facilities. 6 6 Practicum - availability of clinical facilities and preceptors. 6 6 Teaching at both graduate and under­ graduate levels - how teaching load is handled. 8 4 Whether the program is going to be offered full-time or part-time: - Would a part-time program be approved or funded? - Are there part-time programs in other graduate schools? 8 4 Size limitations. 10 3 Admission standard. 10 3 Grant probability and follow-up commitment of the college. Other items mentioned by the faculty but not entered above Included: a. Combating with "expensive" image on campus (the Nursing Department is seen by the campus community as an expensive progra m ), b. Outreach program offering. c. Summer courses. d. Graduate asslstantships, and e. Release time for faculty (the faculty request that the release time be provided for scholarly activities). It is evident from the above list that some of the Items identified were dealt with during the first session. Two meetings that took place one month apart for this group may have caused the faculty to lose track of the items that were already discussed and other Items that were to be dis­ cussed. Keeping academic concerns and administrative con- erns separate for discussions were also difficult. 155 Concerns, questions, and ideas contributed by the faculty during the second session however, were related more to minor details than those discussed during the first session. Highlights of some .of the items discussed are as follows: • The need for adequate budgetary support is the item of most concern among the faculty members. The discussion included adequate staff, library, advising, compu­ ters, and student facilities. • Again the organizational structure is the second ranked area of concern. The questions such as "What would be the structure of the Department?" and "What would be the responsibilities of the chair?" were raised. • Administration's commitment to recruitment and retention of the faculty members is the third ranked administrative concern. • The group recommends that the department should keep other departments informed about the proposed program as well as to receive input from them. • The group wants to know how the teaching load will be handled if a faculty member was to teach both at the undergraduate and graduate levels. • The faculty is also curious about the probability of a grant being offered and whether or not the college is willing to make a continued commitment to support the program. • Another area of concern is how to deal with our "expensive" image across the campus. • Other areas mentioned include: whether or not the proposed program accounts for "out­ reach" offering, plan for the summer courses, provision for graduate assistanceships and release time for faculty for research activities. 156 This section described the concerns, issues, and ques­ tions posed by the faculty of the School of Nursing. The major concerns of the faculty are the extent of their involve­ ment in the program and the timing of the development of the proposed program. After the Dean of the School of Nursing clarified many of their questions, the group contributed their ideas more freely relative to the proposed program. The next section reports the results of the SVSC CollegeWide Faculty Task Force Group. 157 SVSC COLLEGB-WIDE FACPLTY TASK FORCE GROPP Seven faculty members across various disciplines attended the January 23rd meeting. hours, The meeting lasted two again using the nominal group process. This group also addressed the same two questions that were dealt with by the Nursing Faculty Group, they were: 1. What academic considerations should be addressed related to the development of a graduate Nursing Program at SVSC? 2. What administrative and financial plans do you think we should address? In regards to both questions, the following areas of concerns and questions were identified. The Items were again ranked from the most important to the least Important as f o ll ow s■ 158 Rank Points Areas of Concern 1 18 Cost benefit analysis of needs a ssessment. 1 18 Flexibility in purpose - respond to needs and trends of the future. Capture the future in the program. 3 14 Faculty availability: - 4 12 5 9 Financial and logistic administration. 6 support from Quality/standards for admission, retention and graduation: - 6 Recruit new faculty, Increase in faculty, Qualification, Stability/mobility of faculty, Recruitment of Ph.D. faculty, Subjects needed, credit hours, Establish a core, Flexibility in number of hours, Qualified students or interested students. Cost effectiveness: - Allocation of resources 7 1 Placement of graduates in mainstream careers (integrations): - Job availability Other items identified but not included as high priority items: a. Number of students in terms of long-term and short-term, b. Adequacy of faculty's administrative and/or clinical skills, c. Sufficient community support in the direction identified by educators, d. Relationship of MSN degree to Ph.D. (Our MSN qualify for admission in Ph.D. programs elsewhere?), e. Identify competition, f. Data re: Impact of new MSN program on current BSN program, and g. Student recruitment - proximity of students, - non-mobile nature of students, - adequate enrollments, - identify the unique feature (e.g., part-time), and - specialization is a limitation. 159 This group raised many concerns and questions other groups had not identified. insights that The group also shared their from the experience gained within their own graduate programs or disciplines. The highlights of the meeting are described below. • The group is interested to know to what extent the feaslblity study will be helpful for the future planning and implementation of the program.• The group felt the program should be built with flexibility in mind to accommodate trends and changes in the future. • The group is concerned about the av ai l a ­ bility of of qualified faculty. Some of the questions raised include: Will the new faculty be recruited? Will the members of faculty increase beyond the current department level7 What qualification would be required of a faculty member? How recruit­ ment and retention of the faculty be dealt with? • Another concern is to what type of financial and logistic support will be provided by college administration. • Also raised are the concerns in academic matters such as admission criteria, content area, and graduation requirements. e Cost effectiveness of the program are another area of concerns Identified. • The final item of concern is whether or not our graudate would have Jobs matching their academic background. • Other items mentioned are similar to those identified by the Nursing Faculty Group. • Some of the general concerns listed by this group at the end of the session included: 160 - A new program cannot entirely depend on soft money. Administration's com­ mitment for continued support must be present from the outset. - How do we deal with a new program when there are staffing problems campus-wide• - How can the program be developed to minimize the gap with the work world? - Will there be cognate courses outside nursing that can be used, or will special courses be developed for this purpose? This section reported the results of the SVSC CollegeWide Faculty Task Force meeting. This group meeting was beneficial in that a new set of questions and concerns were raised by this group from a college faculty's perspective. SUMMARY OF THE RESULTS OP THE TASK FORCE GROPP METHOD This section described the results of four separate Task Force Groups that represented various constituent groups. The need for a MSN program was identified through the perspectives of both potential students and potential employers. Issues and concerns were also Identified by each of the Task Force Groups. Data obtained through this method were used for the development of three different survey ques­ tionnaires. as well as. to make a judgement about the feasi­ bility of developing the program. The next section will describe the data obtained through the social indicator method. 162 SOCIAL INDICATORS METHOD The purpose for including the social indicators in the feasibility study was to supplement the information obtained through surveys and Task Force Method in an effort to show the types of need and evidence of each in relation to the proposed program. Social indicators were also used for establishing a data base prior to conducting the surveys. This section describes demographic and statistical data that identify the size and the population characteristics of the area within 50 miles of SVSC. Included in this area are 10 counties and parts of eight other counties as shown in Figure 6. 163 F ig u r e 6. SVSC a n d th e S u r r o u n d in g 18 C o u n ty A re a SVSC 16L , Data desc rib ed here trends, include d e m o g r a p h i c profiles social and e conomic charac te ris tic s, tistics. manpower Data in regards to health care and and health s t a ­ services and nurse p r o j e cti on will also be addressed. Characteristics of the Population in 18 County Area The total population of the SO mile area in 1980 was estimated as 83, 1,226,022 p. 26-33). (Michigan Statistical Abstract, 1982- This number is projected to increase to 1,256,290 by the year 1990 (Michigan Department of Manage­ ment and Budget, and 1990. 1985), a net gain of 30,268 between 1980 Between 1970-1980 this area showed a population Increase of 11.52 while Increase between 1980 and 1990 has been predicted to be minimal. The racial composition of the entire 18 county area (all demographic data described below have been drawn from the Michigan Statistical Abstract, White Black Spanish origin American Indian Asian Other 1982-83) is as follows: 87.4Z 8.22 2.22 0.52 0.32 1.32 Sixty-five percent of blacks and 752 of those with Spanish origin live within three counties: Bay, Genesee, and Saginaw. The percentage distribution of the area population by age in 1970 and 1980 Include: 165 1970 17 years or younger 17-65 years 65 years or older Note 1980 38.00% 52.27% 9.73% 30.94% 57.96% 11.10% that the percentage for those with 17 years or younger has decreased, while the percentage of those with 65 years or older has Increased. Live birth rates of Michigan In 1970 were 2,584.5/1.000 women while It has decreased to 1,761.5/1,000 women In 1980. Maternal and infant death In Michigan have also decreased as shown below. Maternal death Fetal death Perinatal death Under 1 year death 1970 1980 29 2,060 4,522 3,492 16 1, 176 2,276 1,851 Life expectancy of the Michigan residents compared to that of the entire U.S. are shown as follows: (Data speci­ fic to 18 county area not available.) 1970 Michigan Male Female 1980 70.0 76.8 70.2 76.9 1976 U.S. Male Female 69.9 77.6 166 Number of deaths from six leading causes among Michigan residents in 1970 and 1980 is shown as follows. 1970 1980 Heart Disease Cancer All Forms 29,204 29,790 13,551 15,828 Accidents A '^ Motor All Vehicle Forms f Cerebral Vascular Disease 7,691 6,164 2,309 1,880 4,428 3,627 Diabetes Pneumonia and Influenza 2,180 1,467 2,101 1,808 Socioeconomic Data Median income of the families of the 18 county area according to the 1980 census is $18,642 while that of the families throughout Michigan is $22,108. The percent of the persons living in households with income below the poverty level in the 18 county area is 11.8 compared to that of 10.4 in the State of Michigan. Unemployment 17. 6 Z rate of the 18 county area ranges from (Genesee and Shiawassee counties) County) in 1980. unemployment to 8. IX (Isabella All but three of the 18 counties showed an rate of over 13%. high as 20.2% in two counties. In 1982, the rate was as Unemployment rate in Michigan in 1982 was 15.5% while that of U.S. was 9.7%. As the economic conditions improved over the past three years, the rate of unemployment decreased slightly compared to the 1980-82 rate. Over the decade from 1970 to 1980, this area had experienced a great deal of Increase in the educational level of the residents. school graduates In 1970, the percentage of high (person 25 years and older) was 50% while a 167 15Z increase in Che pe rce nta ge of high school gradua te s had been obser ved by the 1980 census. The above data briefly scanned the demographic and socioeconomic characteristics of the 18 county area. It was the author's intent to describe health care needs of the entire 18 county area as a part of the feasibility study. However, such extensive data are not readily available. Therefore, the local data available in Saginaw County will be presented here. During the Fall of 1985 the United Hay of Saginaw con­ ducted a community-wide needs assessment for health care and human services in Saginaw County. The highlights of the study will .be described in the following section. 168 U N IT E D HAY MEEDS ASSESSMENT The survey was conducted Saginaw County to assess by the United Way of the the scope and intensity of commun­ ity need for human service programs (United Way of Saginaw C o u n t y , 1986). Background of the Stndy The following describes the characteristics of Saginaw County as described by the study group: 1. Saginaw County's current population is 220,200. Although there have been steady increases in population between 1941 and 1981, It Is not expected to grow in the near future. 2. Minorities will continue to consti­ tute 202 of the county's population. Minorities are expected to grow as a percent of the population with the greatest concentration In the City of Saginaw. 3. Individuals within the 34-54 age range are Increasing as a percent of popula­ tion. The number and percentage of the population 75+ years old will also Inc r e a s e . 4. Rising costs will continue to cause changes to occur in health care delivery systems. 5. A large percentage of women with chil­ dren under six will remain in the work force. 6. Local unemployment will continue to decline but will remain above the national average. 7. Most of the growth in employment will occur in companies employing 29-99 persons. Manufacturing will continue to provide most area jobs, however, increasing employment will occur in the service and professional categories. 169 Survey Findings In order to conduct Identified: this study, general public, munity leaders. three populations were service providers, and key com­ Description of the major problems identi­ fied by the survey follows. All groups surveyed agreed that drug, alcohol abuse and child abuse-neglect constitute the largest problem for the community. Among other health related issues and concerns identi­ fied by the general public group included (in the order of weights assigned by the respondents): 1. Lack of supervised community housing and adult foster care for persons unable to care for themselves. 2. Lack of 3. Lack of birth control counseling for t eenagers. 4. Lack of public dwareness about mental retardatio n . 5. Lack of 6. Violence 7. Lack of financial assistance to cancer patients . 8. Lack of community service for chronic severely mentally ill persons. 9. Lack of rehabilitation programs for persons suffering from crippling disa­ bilities . 10. low-cost health care. services for teenage mothers. against elderly family members. Lack of community mental health ser­ vices for needy persons experiencing depression or marriage and family prob­ lems or funding for such services. 170 11. Lack, of available assistance to indi­ viduals with mental retardation. 12. Lack of information related care issues. 13. Lack of housekeeping assistance for ill people. 14. Lack of in-home- skilled nursing care. to health This study revealed a number of problems that needed collaborative efforts among many disciplines and agencies. The data provided by this study also is very valuable for the nursing profession in the community. In this section, the results of the United Way Needs Assessment Report was presented. indicators, As a part of the social the next section deals with health care agencies of the 18 county area. 171 HEALTH CARE AGENCIES WITHIN 18 COOHTT AREA The 18 county area surrounding SVSC has all types of health care agencies ranging from facilities capable of open heart surgeries to rehabilitation hospitals and hone-care agencies* The chart below lists the type and number of health care agencies as listed by the Michigan Department of Public Health: Health Care Agencies in the 18 County Area (Within SO Miles from SVSC) Number of Agencies Types of Agencies Hospitals with bed capacity over 150 Hospitals with bed capacity below 150 Nursing care facilities (long-term care units, medicare and medicaid certified) Facilities for psychiatric or developmentally disabled persons Community health agencies/ visiting nurses associations (medicare certified) Home health care agencies (medicare certified) The above presented Total Bed Capacity 13 3,954 21 1,674 31 3,545 2 930 10 12 the type and number of health care agencies in the 18 county area (within 50 miles The following describes national, related to the nursing profession* 172 from SVSC). state and local statistics LOCAL. STATE AHD NATIONAL STATISTICS RELATIVE TO REGISTERED NURSES According to the Institute of Medicine study (1983, 65), it was estimated that there were in the nation in 1982. p. 1,360,000 active RNs Expressed as a population ratio, supply of RNs per 100,000 population was 572. the It has been reported during the 60's and 70's that there were critical shortages of registered nurses. On the contrary, the supply of the registered nurses doubled between 1960 to 1980. The problem of registered nurse supply in the 80's Is no longer the shortage of the absolute number of the registered nurses, but a disproportionate number of RNs in each cate­ gory of educational preparation. As of 1980, nation-wide supply of approximately RNs, of the overall 1.27 million employed 20Z had an associate degree as highest level of educa­ tional attainment, 51Z had a diploma, laureate or higher degree. and 29Z had a bacca­ RNs with an associate degree (ADN) or diploma still occupy many high level nursing positions. As the health care system becomes more complex, nurse managers, specialists and educators will be required to be much more sophisticated in professional as well as managerial competence. As estimated by the Intermediate projection model by the Institute of Medicine Study (1983, p. 77), the proportion of baccalaureate or higher degree RNs is expected to increase to 36.3X and ADN to 27X of all practicing RNs by 1990. The number of nurses with d i p lom a or ADNs who go on to receive b a c c a l a u r e a t e degree 173 is also growing steadily. It is predicted that almost 40% of the addition to the baccalaureate degree graduate in 1990 would come from this population. Nationally in 1980, 44,700 (3.5% of total active RNs) had masters degrees. The numbers and distribution of mas­ ters in nursing programs in the colleges and universities across the nation have Increased substantially during the past 20 years— from 43 to 141 (Institute of Medicine, p. 141). Each year, 1983, two percent of the BSN graduates go on to receive MSN degrees. If this continues at the same rate there will be approximately 125,000 MSNs In the U.S. by 1990, which is 7.3% of the total RN supply using the pro­ jection model adapted by the Institute of Medicine Study Group (1983, p. 77). However, this number is much lower than the 256,000 for 1990 projected by the Department of Health and Human Ser­ vices using the Western Interstate Commission on Higher Education (WICHE) model. criteria model, The WICHE model is a judgement of recommended by a panel of professionals who projected the number of MSNs. The former model adapted by the Institute of Medicine Study Group is a model based on the historical trend of a nurse manpower needs. the WICHE model is more a professional Obviously, standard or In other words a desired state of the profession which will require much more vigorous efforts if it were to be attained. Addressing the future supply of registered nurses in the nation, the committee of the Institute of Medicine Study 174 identified problems that cannot be resolved by merely Increasing the supply of nurses with basic education, can be alleviated by increasing advanced education. but the supply of nurses with The committee concluded: Unlike the situation with respect to basic supply of generalist nurses, where we have found the likelihood of a general balance between supply and demand in 1990, there is both a serious current and probably 1990 shortage of nurses educationally prepared for administration, teaching, research, and advanced clinical specialties ..., there is such an obvious gap between the present supply and educational capacity of the sys­ tem on the one hand even conservative esti­ mates of future advanced positions required on the other, that existing program capa­ city and sources of student support at the graduate level should be expanded (p. 149). The nation-wide statistics and problems cited above also are true in Michigan and the Saginaw area. to Michigan State Health Plan 1983-1987 According (1983 p. 59), there were 41,800 registered nurses (full-time equivalent), which provide a supply of 445 RNs per 100,000 population. It is estimated that the number of RNs will increase to 52,000 (526 per 100,000) in .1990. tional background in 1979, Distribution of RNs by educa­ and projection for supply and demand for 1990 are as follows: 175 1990 Projection Educational Preparation 1982 Supplies FTE Per 100,000 Population Supply FTE Per 100,000 Population ADN/D.iploma BSN MSN Doctorate 337 (75.7Z) 91 (20. 4Z) 16 ( 3.6Z) __ l_ ( •2Z ) 349 145 30 __ 2 Total 445 526 (66.3Z) (27.6Z) ( 5.7Z) ( -4Z) 296 170 37 __ 3 (58.5Z) (33.4Z) ( 7.3Z) ( -6Z) 506 (Adapted from the Michigan State Health Plan, p. 73.) As shown above, Demand FTE Per 100,000 Population 1983-87, 1983, there will be an excess of ADN/diploma nurses but a significant under-supply of BSN, MSN and doc­ torate nurses in the State of Michigan by 1990. Thus, if the actual 1990 supply is to match 1990 demand, educational capacity will have to be changed to graduate fewer ADN/ diploma nurses and more BSNs or higher degree nurses. Locally in the 14* county area surrounding SVSC, distribution of RNs by educational background in 1979 and number projected for 1985 for total supply was as follows: 1979 (Actual) ADN/Diploma BSN (BS/BA) MSN Doctorate 2,676 358 75 1 Total 3,110 (86 .0Z) (11 •5Z ) ( 2 .4Z ) ( o .0Z) 1985 (Projected Supply) 2,450 (78.2Z) 578 (18.5Z) 102 ( 3.3Z) No t Av ailable 3,130 ♦Eighteen county area data are not available therefore, the 14 county area data will be addressed (East Central Health Systems Agency, Inc., 1981). 176 As of December, 1985, there were 5,631 registered nurses In the surrounding 1A county area (Michigan Board of Nursing, 1986). According to national statistics three- fourths of the registered nurses are known to be employed (Institute of Medicine, 1983, p. 65). Thus, the approximate number of active RNs as of December 1985 in 1A county area Is A,223. Taking 835,18A In 1985, the population of this 1A county area of the RN supply for this area as of 1985 would have been 506 per 100,000 population. beyond what has been projected for 1985 This number is (A85 per 100,000 calculating from 1990 projection of Michigan data described above). However, these data are estimates, and must be carefully interpreted In light of slow population growth or even loss In this area in the past five years. Current data on distribution of RNs by educational background Is not available locally. 1980 and 1990 data in Michigan, Extraporating from distribution of RNs by edu­ cational background is approximately as follows: Percent Projected for 1985 ADN/Diploma BSN MSN Doctorate 71.01 2A.0Z A. 7 Z .1Z Number of 1985 as Estimated 2,998 1,013 198 A2 From the researcher's observations of the surrounding 1A county area it is unlikely that such a distribution had been attained as of 1986. 177 In this section national, state, and local data related to nursing has been presented as they related to the distri­ bution of RNs by educational background. It is evident from above that the shortage of the absolute number of RNs Is no longer present according to historical projection model, but the lack of sufficient number of RNs with higher academic preparations is the primary concern. SDMMARY OF SOCIAL INDICATOR METHOD The information obtained through existing data relevant to the planning of the proposed MSN program have been pre­ sented above. Included in these information were demo­ graphic characteristics and socioeconomic statistics related to the population in the surrounding 18 county area as well as national, state, and local statistics related to the registered nurse population. The data presented above will be taken into account as the survey data and the data col­ lected through the Task Force'Group method are to be analyzed in the next chapter. 178 SECTION TWO: ASSESSMENT THE RESPLTS OP THB KVALPATIOM OP THK HERDS This section reports the evaluation of this needs assessment according to three phases: mentation, preparation, Imple­ and outcome* Phase It Evaluation of the Preparation Phase of the Heeds Assessment A set of questions prepared by Stufflebeam (1985, 197) was used to evaluate this phase. p. The following reports whether or not the preparation phase of the needs assessment met the standards. 179 E v a lu a tio n R e s u lts : Major Heading/ Topics of Evaluat ion P r e p a r a tio n Phase o f Questions Related to _____ the Topics_____ th e N eeds A ssessm ent Whether or Not Questions Were Addressed (Yes/No) Elaboration Conceptualiza­ tion of Needs Assessment: 180 « Definition How is needs assess­ ment defined? Yes Purpose What purpose(s) will it serve? Yes Research Ques­ tions What questions will it address? YeB Information What information is required? Yes Audiences Who will be served? Yes Agents Who will do it? Process How will they do it? Yes Standards By what standards will their work be j udged? Yes Yes, Partially Addresses to decision makers at all levels. The relationship of the researcher to the study was not explained in the proposal, These standards were not avail­ able when original proposal was prepared, but obtained as the study began. E v a lu a tio n R e s u lts : Major Heading/ Topics of Evaluation P r e p a r a t io n P h a s e o f t h e N e ed s A s s e s s m e n t Questions Related to the Topics Whether or Not Questions Were Addressed (Yes/No) (C o n tin u e d ) Elaboration Sociopolitical Factors: 181 Involvement Whose sanction and support is required, and how will it be secured? Yes Internal Com­ munication How will communication be maintained between the needs assessors, the spon­ sors and the system personnel? Yes Internal Credibility Will the needs assessment be fair to persons inBide the system? No External Credibility Will the needs assessment be free of bias? Yes, Partially Not addressed in the proposal* Indicated in the methodology section (sampling method and procedure). The fact that researcher is an inside agent - a potential source of bias is not addressed. Evaluation Results: Major Heading/ Topics of Evaluation Preparation Phase of the Needs Assessment (Continued) Questions Related to the Topics Whether or Not Questions Were Addressed (Yes/No) Elaboration What provisions will be made to maintain security of the information? Yes Protocol What communication channels will be used by the needs assessor and sys­ tem personnel? Yes Public Relation How will the public be kept informed about the intents and results of the needs assessment? Yes, Partially Plans for public dissemination of the results were not addressed completely in the proposal. Who is the sponsor, who is the assessor, and how are they related to what is being studied? Yes, Partially Relationship of the assessor and the subject being studied were not explained in the proposal. 182 Security Addressed by compliance with a set of guidelines provided by the Committee for the Protec­ tion of Human Subjects Contractual/ Legal Arrange■eats Client/Needs Assessor Rela­ tionship Evaluation Results: Major Heading/ Topics of Evaluation 183 « Preparation Phase of the Heeds Assessment (Continued) Questions Related to the Topics Whether or Not Questions Were Addressed (Yes/No) Needs Assess­ ment Products What are the intended outcomes of the needs assess­ ment? Yes Delivery Schedule What is the schedule of needs assessment activities and pro­ ducts? Yes Editing Who has the author­ ity for editing report s? No Access to the Data What existing data may the needs assessors use, and what new data may they obtain? Yes Release of Reports Who will release the reports and what audiences may receive them? Responsibility and Authority Is it clear as to who is to do what in the needs assessment? Yes, Partially Yes Elaboration Not addressed in the proposal. Not explicit in the proposal. Evaluation Results: Major Heading/ Topics of Evaluation Finances Preparation Phase of the Heeds Assessment (Continued) Questions Related to _____ the Topics Have the necessary resources been determined and is it clear how they will be provided? Whether or Not Questions Were Addressed (Yes/No) Yes, Partially Technical Design: Objectives and Variables What is the needs assessment designed to achieve, in what terms should it be evaluated? Yes Investigatory Framework Under what conditions will the information be gathered, for example, case study, survey, site review, e t c .? Yes Instrumenta­ tion What information gathering Instruments and techniques will be used? Yes Sampling What samples will be drawn, and how will they be drawn? Yes Elaboration Budget plan was not Included the proposal, but treated as regular expense item of the School of Nursing. Evaluation Results: Major Heading/ Topics of Evaluation Preparation Phase of the Heeds Assessment (Continued) Questions Related to the Topics Whether or Not Questions Were Addressed (Yes/No) Elaboration How will the informa­ tion gathering plan be implemented, and who will gather the infor­ mation? Yes Data Storage and Retrieval What format, proce­ dures, and facilities will be used to store and retrieve informa­ tion? Yes Data Analysis How will the informa­ tion be analyzed? Yes Reporting What reports and tech­ niques will be used to disseminate the find­ ings? Yes, Partially The plans for dissemination were not included in the pro­ posal. Technical Adequacy To what degree will the needs assessment Information be reli­ able, valid, and objective? Yes, Partially The survey instruments were pilot tested and revised, but not empirically. 185 Information Gathering Evaluation Results: Major Heading/ Topics of Evaluation Preparation Phase of the Heeds Assessment (Continued) Questions Related to the Topics Whether or Not Questions Were Addressed (Yes/Ho) Elaboration Management Plan: Organizational Mechanism What organizational unit will be used to do the needs assess­ ment Can in-house office of evaluation, a self-evaluation system, a contract with an external agency, a consortiumsupported evaluation center, etc.)? Organizational Location Through what channels could the needs assessment influence policy formulation and administrative decision-making? Yes, Partially Not fully explained in the proposal. Policies and Procedures What established and/or ad hoc poli­ cies and procedures will govern this needs assessment? Yes, Partially Complied with the policies of the Committees for Protection of Human Subjects at MSU and SVSC. Staff How will the needs assessment be staffed Yes No Not included in the proposal. Evaluation Results: Major Heading/ Topics of Evaluation Preparation Phase of the Needs Assessment (Continued) Questions Related to the Topics Whether or Not Questions Were Addressed (Yes/No) Elaboration Facillties What space, equip­ ment and materials will be available to support the needs assessment? Data Gathering Schedule Hhat Instruments will be administered, to what groups, accord­ ing to what schedule? Yes Clearly explained. Reporting Schedule Hhat reports will be provided, to what audiences, according to what schedule? No Not addressed in the proposal. Training What training will be provided to what groups and who will provide It? Yes Instructions for the selection of appropriate subjects and the distribution of questionnaires were explained by a letter. Yes, Partially Facilities and equipment needed were specified for the group method, but not others. Evaluation Results: Major Heading/ Topics of Evaluat ion Preparation Phase of the Heeds Assessment (Continued) Questions Related to the Topics Whether or Not Questions Were Addressed (Yes/No) Will this needs assessment be used to aid the system to improve and extend its internal capability to assess needs? No Not indicated as such though this study will benefit the future needs assessment of the School of Nursing. Budget What is the Internal structure of the budget? How will it be monitored? No Not Included in the proposal. Expense was treated as regular expenses. Philosophical Stance What is the value base for the needs assessment? Yes Service Orientation What social good, if any, will be served by this needs assess­ ment, and whose values will be served ? Yes 188 Installation of Needs Assessment Horal/Ethlcal/ Utility Ques­ tions : t Elaboration Evaluation Results: Major Heading/ Topica of Evaluation Preparation Phase of the Needs Assessment (Continued) Questions Related to the Topics Whether or Not Questions Were Addressed (Yes/No) Elaboration Assessor's Values Hill the needs assessor's technical standards and his values conflict with the client systems and/or sponsor's values? Will the needs assessor face any conflict of interest problems? What will be done about possible con­ flicts? Judgements Will the needs assessor Identify needs or leave that up to the client? Or will the assessor obtain, analyze, and report the judgements of various reference groups? Yes The proposal Indicated that the data will be collected from the various reference groups and existing data, but an ultimate judgement will be made by the client. Obj ectivity How will the needs assessor avoid being coopted and maintain his/her objectivity? Yes The proposal addresses the objectivity and limitations as study design and methodology were described. Yes, Partially Identified by the researcher as is sites to be taken into account as this study was con­ ducted, but not made explicit in the proposal. Evaluation Results: Major Heading/ Topics of Evaluation 190 « Preparation Phase of the Heeds Assessment (Continued) Questions Related to the Topics Whether or Not Questions Were Addressed (Yes/No) Elaboration Prospects for Utility Uill the needs assessment meet utility criteria? Yes, Partially Utility of information was a primary concern of the researcher, but standards per se were not available before the study was began. Cos t/Effect iveness Compared to its potential payoff, will the needs assessment be imple­ mented at a reason­ able cost? Yes, Partially The study addresses this sub­ ject as the survey design was explained, but its relation­ ship to the study's payoff was not addressed. Phase IIi Evaluation off the I«ple«entation Phase Following the format used for the evaluation of the preparation phase, the reports of the evaluation of the implementation phase are described as follows* The ques­ tions Included In the reports were drawn from Stufflebeam, et al. (1985, p. 195). 191 Evaluation Results: 192 4 Implementation Phase of the Needs Assessment Whether or Not Questions Were Addressed (Yes/No) Major Heading/ Topics of Evaluation Questions Related to the Topics Job Performance of the Assessor Is the needs assessor on board doing the job? Yes During the weekly meeting with the Dean of the School of Nursing and Allied Health, researcher's job performance was reviewed. Proper Implementation Is the plan carried out appropriately? Yes Monitored weekly by the researcher and discussed with the Dean on weekly basis. Progress of the Study Is the plan on schedule? Yes Monitored on a weekly basis. Soundness of Instruments Are the data collection instruments sound? Yes The survey instruments were pilot tested, as well as receiving feedback from the Dean and two researchers on campus. Elaboration Adequacy of Information Is an adequate and appropriate amount of information being accumulated? Yes Monitored during the weekly meeting with the Dean. Adequacy of Resources Are sufficient resources being invested in the needs assessment? Yes Discussed with the Dean on weekly basis. Additional resources, e.g., human resources provided as needed. Evaluation Results: Major Heading/ Topics of Evaluation Questions Related to the Topics Whether or Not Questions Were Addressed (Yes/No) Elaboration Are the relevant authority figures supporting the study appropriately? Yes Discussed during the weekly meeting and appropriate support obtained from the college and surrounding health care agen­ cies . Adequate Communication What communication are being issued, and are the audience finding them of use? Yes - Monitored by the researcher improvements made where needed. - Discussed during the weekly meeting. Revision of Plans Should the needs assessment plan.be revised? Yes Discussed with the Dean minimal changes were made except for the time schedule that needed exten­ sion , Are there any Issues to be resolved during the implementation? Yes Identified by the researcher through feedback from the con­ stituent groups. The issues were discussed to seek a solu­ tion. 193 Support by Relevant Author!ty Issues in Implementing Needs Assessment « Implementation Phase of the Needs Assessment (Continued) Phase III: The Evaluation of Outcoae results of the evaluation of the needs assessment outcome will be presented here according to the standards identified by the Joint Committee on Standards tional Evaluation (1981). for Educa­ The evaluation was documented using "Standard Criterion Form" prepared by the Joint Committee * The form lists, in the first column, pared by the Joint Committee, space for numbers and in the middle column, corresponding to an appropriate as determined by the evaluation results. provides a space evaluation. a category The third column for comments or further elaboration of the The standards are classified according to the four major attributes of evaluation: propriety, 30 standards pre­ and accuracy. 194 utility, feasibility, Evaluation Results: Outcome of the Needs Assessment Codes for standards for applicability and compliance: 1 * The standard was deemed applicable and to the extent feasible was taken Into account. 2 - The standard was deemed applicable and was taken into account, but not thoroughly. 3 - The standard was deemed applicable, but was not taken Into account. 4 - The standard was not deemed applicable. 5 - Exception was taken to the standards. Standards 195 A. * Applicability and Conpliance (See Codes) Comments Dtility Standards: 1. Appropriate audiences were identified. 1 2. The researcher credibility was established. 1 3. Information scope and selec­ tion were appropriate. 1 A large volume of informa­ tion collected for use in program planning. 4. The rationale and procedures for interpreting the findings are clearly described. 2 Not completely explicit in report. 5. Concise needs assessment report was prepared. 1 A complete report was pre­ pared. More concise report for appropriate audiences needs to be prepared. Standards Comments 6. The report was distributed to the appropriate audiences. To be completed before September, 1986. 7. The report was delivered on tine. With the best of ability, attempts were made to be on time. 8. The needs assessment was conducted in ways that encouraged follow through by the members of the audiences. To be evaluated In 6 months and 1 year. 196 B. Applicability and Compliance (See Codes) Feasibility Standards: 1. The needs assessment proce­ dure was practical so dis­ ruption is kept to a minimum. 1 The researcher encountered some difficulty with three agencies for conducting the sureys. 2. The needs assessment should be planned and conducted with anticipation of Issues and adversary positions of vari­ ous constituents. 1 Issues identified and dis­ cussed with each constituent group. 3. The needs assessment produced Information of sufficient value to justify the resources expended. 1 Standards C. Applicability and Compliance (See Codes) Comments Propriety Standards; Obligations of the formal parties to needs assessment were agreed to In writing. 2 2. Conflict of Interest was dealt with openly and honestly. 1 3. Oral and written needs assess­ ment reports were open, direct, and honest in disclosure of pertinent findings including the limitations of the needs assessment. A. The formal parties to needs assessment Insured the public's right to know. 1 5. The rights and welfare of the human subjects were respected and protected. 1 6. The needs assessors respected the human dignity and worth In their interactions with others associated with the study. 1 197 1. Formal written contract occurred after the proposal was prepared. All the reports whether they are positive or negative were documented as responded, The committees for protec­ tion of human subjects both MSU and SVSC approved the project. Standards Applicability and Compliance (See Codes) Comments 7. The needs assessment was com­ plete and fair in its presenta­ tion of strengths and weaknesses of the program. 1 8. The need assessor's allocation and expenditure of resources reflected sound accountability procedures and otherwise prudent and ethically responsible. 2 A budget plan was not included in the proposal. The expenses of the needs assessment were shared between SVSC and the researcher. The Dean of the School of Nursing authorized each major expense. Accuracy Standards: 1. The group whose needs are being assessed were sufficiently examined for clear identification and characterization. 1 The design of the study accommodated for this stan­ dard . 2. The context in which the group exists was examined in enough detail. 1 Background of the study and social indicator method pro­ vided these Information. 3. The purposes and procedures of the needs assessment were described in sufficient detail. 1 Standards 199 4 Applicability and Compliance (See Codea) Comments 4. The sources of information were described In enough detail. 5. The information gathering instruments and procedures pro­ vide valid data. Data input from the Task Force Method gave directions as to what questions to be Included in the survey. The content, criterion-related, and construct validities of the survey Instruments are evident, though not proven empirically■ 6. The information gathering instruments and procedures insured reliable data. The survey instruments were pilot tested for clarity. Reliability was not tested empirically, but Bufficently reliable for intended use. 7. The data collected were reviewed and corrected so that the results are accurate. Reviewed by a specialist In measurement and evaluation. 8. Quantitative information was appropriately and systemati­ cally analyzed. 1 SPSS was used with an assistance of the individual with experience in data processing. Standards 9. 200 i Qualitative information was appropriately and systemati­ cally analyzed to insure supportive interpretation. 10. The conclusions reached in a needs assessment must be based on sound logic and appropriate information. 11. The findings are objectively reported. Applicability and Compliance (See Codes) 1 1 Comments Criteria were determined for each of the research ques­ tions to assure appropriate answers. THE SUMMARY OF THE RBSPLTS OF THE EVAI.PATIOH The results of the evaluation In each phase of the study were presented using specific criteria for each phase. The Joint Committee's Standards for Educational Evaluation were used as a conceptual framework for evaluation. results The revealed that the majority of standards were met. There were a few standards which were not met. These Items will be discussed along with the strengths and limitations of this needs assessment in the following chapter. The next chapter will address the primary research questions as well as subsidiary questions chapter one. 201 presented in IMPLEMENTATION AND EVALUATION OF A FEASIBILITY STUDY FOR A PROGRAM LEADING TO A MASTERS OF SCIENCE IN NURSING AT SAGINAW VALLEY STATE COLLEGE By Sachiko Kanegae Claus VOLUME II A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Adult and Continuing Education August, 1986 CHAPTER T: In this chapter, DISCUSSION data presented In the previous chapter will be discussed under the heading of each research ques­ tion. As described in chapter, one, a set of subsidiary research questions accompanied each primary research ques­ tion. The first section of this chapter deals with a set of questions related to the first primary research question, and the second section deals with those related to the second primary research question. The criteria to judge the results for each subsidiary research question will be identified before the discussion. These criteria were identified based on the following: 1. The guidelines provided by National League of Nursing: Developing a master's program in nursing (Epstein, 1978) . 2. Institute of Medicine Study report (Institute of Medicine, 1983). 3. Standards for Evaluations of Educa­ tional Programs, Projects and Mate­ rials (The Joint Committee on Stan­ dards for Educational Evaluation, 1981). 4. The researcher's judgement for needs and resources required to substan­ tiate the proposed master's program at SVSC. 202 PART I : I. PRIMARY RESEARCH QUESTIONi ARK THERE SOBSTAHTIAL NEEDS AND RESOPRCBS FOR THE DEVELOPMENT OP A MSN PROGRAM AT SVSCT Potential Students: A* How nany registered nurses with a BSN as their highest degree are employed within a SO Mile area? Criterion: Based on the projection by Michigan State Health Plan (1983) there should be at least 1,000 active BSNs in the SO Mile area (18 county)* Determining the size of the BSN population In this area Is important Cor two reasons* One of the reasons Is that the proportion of the BSNs to the ADNs and Diploma Nurses has been known to be very low, and that more BSNs are needed in this area. The other reason is that there must be an adequate number and continuing supply of BSN graduates to provide a potential student pool for the proposed MSN pro­ gram. Current data on the exact size of BSN population in the eighteen county area is not available except for estimation. In 1979, there were 358 baccalaureate degree RNs in the fourteen county area as estimated by East Central Health Systems Agency, Inc. (1981). The agency projected that the number of BSNs would have been 578 by 1985. The Potential Employer Survey of 61 agencies in the eighteen county area revealed that there were 312 BSNs in the 28 agencies which responded to this question. Survey, the total number of BSNs in the BSN programs), In the RN (and those who are enrolled currently employed by the sample 203 agencies were estimated to be approximately 600. ber of BSNs and the potential BSNs The num­ (RNs who are currently enrolled in the BSN program) within 50-mile area were estimated to be approximately 1,100. This number was derived from the Registered Nurse Survey. The procedures followed to arrive at this number will be described in Appendix U, As for determining the continuing supply of potential students for the proposed MSN program, the graduates of the Generic and RN Baccalaureate Program at SVSC, and the Bacca­ laureate Program for RNs at the University of Michigan, Flint would add to the number of BSN population in this area each year. As described above, BSNs currently, there exists approximately 1,100 as well as a continuing source of potential student pool within fifty miles. 204 B. What proportion of the above population is eligible and interested in being enrolled In the STSC Graduate Nursing Program within the next two to three years? Criterion: At least 50Z of the BSN and potential BSN population will be eligible and interested in the SVSC graduate progran. Of 291 R.N. respondents in the Registered Nurse Survey, 252 (882) reported that they would meet the qualifications as applicants of the program. Among those, 192 respondents (76%) meets the qualifications currently and the remaining 60 respondents (24%) reported that they would be able to meet in two to three years. the qualifications, Among the 252 R.N.s who meets 195 (77%) responded that they are inter­ ested in the proposed MSN program. Figure 7 illustrates these statistics described above. Do have Qualifications. ■Do not have.. Qualifications Respondents with interest in N.S.N. m« Respondents without interest in M.S.N. Figure 7. RN Survey (H—291) Interest in the Proposed MSN Program Among Those Qualified Currently or Within Two to Three Tears. 205 I Disaggregation of the category "Interested" revealed that of those, 40 (20Z) responded that they were "definitely" Interested in being enrolled if the program is available within two to three years. The remaining 155 (80Z) responded that they may be enrolled if the program becomes available. These values are slightly different from the value found in Chapter IV. In Chapter IV, the frequency for those who are definitely interested in being enrolled was shown as 46. The discrepancy of 6 respondents not included above is because there were six respondents among the 46 who reported not meeting the qualifications. As illustrated In Figure 8, in the Nursing Student Survey (N ■ 97), 89 respondents (92Z) reported that they would meet the qualifications within two to three years. the 89 respondents, Of 61 (692) reported that they are interested in the proposed program. 206 ■Do not meet Qualifications. Mursing students with nterest ■* n M.S.N. Nursing students, without interest in nsjn. Figure 8. Student Hurse Survey (11*97) Interest In the Proposed MSB Program Among Those Vho Meet Qualifications. As shown above approximately 701 to 75Z of each respon­ dent group studied expressed Interest In the proposed program, Indicating a sizable pool of potential applicants who meet the qualifications and show Interest toward the proposed program. 207 C. What are the characteristics of the potential students who are Interested In the proposed MSN program? Criterion: Data will include the following sample characteristics: a g e t gender, marital status, the number of dependents, place of residence, whether or not currently enrolled In the academic Institutions, type of Institutions employed, clinical specialty areas, and their positions held In the employment setting. Typical demographic characteristics of the R.N. dents who expressed Interest toward Include: dependents, married, female, with either no dependent or one to two and reside within twenty miles from SVSC* Of the 191 R.N. respondents who are Interested in the program 55% are 26 to 35 years old, old, the proposed MSN program within the ages between 26 to 35 years old, Caucasian, respon­ 19% are 36 to 45 years and another 18% are 18 to 25 years old. majority of the respondents are female (96%), Although the there are seven male who are Interested In the proposed MSN program. The racial compositions of the respondents who showed interest in the program consist of 96% Caucasian, and 1% Mexican and American Indian. 2% black, 1% oriental, Seventy-three percent of those who showed Interest in the program are married, another 21% are single. and Fifty percent of the 191 respondents showing Interest in the program have no dependent, with another 40% having one to two dependents. The mean age of the dependents among those who have dependents was found to be 7 years old. There was no significant relationship between the number of dependents or the mean age of the dependents and 208 their plans to pursue MSN degrees. Forty percent o £ the group live within 20 miles from SVSC,- another 382 live between 21 to 5 0 'miles, and the remaining 12X live beyond 50 miles from the college. The typical demographic characteristics of the nursing student group who showed interest in the MSN program Include the ages between 18 to 25 years old, Typically, female, and Caucasian. they are single and have no dependent and reside within 20 miles from the college. Common characteristics of the R.N. fessional background include: being employed full or part- time in the acute care hospital, charge nurse, respondent's pro­ being a Btaff nurse or a and working in an adult medical-surgical unit. Most of them have a baccalaureate degree in nursing, graduated within the past ten years. most of the respondents are employed interested in the program). The hospital (812 of those who are Only one percent is employed by the long-term care agencies. degree, is where Sixteen percent are employed by the community health agencies. dents, and 812 have a baccalaureate degree, Of the 191 respon­ 112 have an associate 52 have a diploma as their highest degrees. Forty-one of the 191 respondents in the R.N. Survey who are interested in the proposed program are currently enrolled in the academic institution. in a BSN program, Of those, 29 (702) are enrolled and others In a variety of academic programs. Adult medical-surgical nursing was listed as their clinical specialty by 422 of this group. 209 Another 302 of them listed critical care or emergency nursing as their specialty. Parent- child health and community health nursing are claimed by 13Z of the respondents. Four percent of the respondents listed psychiatric nursing as t h e i r .specialty area. Of the R.N. respondents who are interested in the program, 69Z are staff or charge nurses, coordinators or clinical managers, 11Z are patient care and another 7Z are nurse educators. The demographic and professional background of the respondents who have shown Interest toward the proposed MSN program have been described above. 210 D. What type of MSB program Is desired by the potential students? Criterion: The R*N* Data will Include potential students' preference for clinical specialty area, functional role, full-/part-tine study, semesters preferred, and preferred class time each seek of potential students. Survey revealed that medical-surgical nursing and parent-child health nursing are two specialty areas pre­ ferred by the respondents. The functional are a clinical nurse specialist, trator and nurse educator. role most preferred followed by a nurse adminis­ The choice of clinical specialties and functional roles preferred by this group are similar to those identified by the Nursing Alumni Task Force. The R.N. respondents plan to pursue their graduate studies on a parttime basis, preferably during the fall and winter semesters, attending classes one to two evenings per week. The Nursing Student Survey revealed that their choice of clinical specialty areas are also adult medical-surgical nursing and parent-child nursing. functional Their most preferred role is a clinical nurse specialist. The nurse educator role was selected as the next most preferred as opposed to the R.N. group who preferred nursing administra­ tion as the second most preferred. There was concensus among the data from the surveys i and the Task Force groups that the potential students plan to pursue their graduate studies on a part-time basis. They prefer to do so during the fall and winter semesters and one to two days per week on week days. I It is evident from above that the potential students prefer a MSN program that would accommodate the needs of the students who are currently in the nursing profession. 212 E. What are the attitudes and concerns of the potential students toward the proposed program? Criterion: — Data will Include attitudes: whether the u j o r l t y feel posi­ tive or negative. — Data will Include concerns expressed by this group. Major concerns of the potential students and nursing students) (both R.N.s relate to the demand of the program in terms of time and cost, and the quality of the proposed program. The greatest concern expressed by this group was whether or not the program offerings match their choice of specialties and functional roles. The demands which the program would put upon the potential students in terras of time and costs were Identified as another major area of concern. The manner the program will be offered (part- time vs. full-time), research, requirements for graduation or others), (thesis, and availability of financial assis­ tance were identified by both survey respondents and Alumni Task Force. The accreditation status of the program also was identified as an important area of concern by this group. However, this item was mentioned more frequently by those who are not interested in the proposed program than those who are interested. According survey questionnaires, to the comments made in the the group who are interested in the proposed program reported that the reputation of the BSN 213 program at SVSC lead them to be optimistic about the proba­ bility of the MSN program obtaining an accreditation. The major concern expressed by the current SVSC nursing students was whether or not the current faculty members could accommodate another new program. The researcher realized that more information should have been provided to this group regarding the new program and the plans for active recruitment of qualified faculty members. As described above, the overall attitude of the poten­ tial students are positive toward the proposed program, and their concerns primarily relate to whether or not the pro­ posed program matches their specialties and preferences. By providing more information toward the development of the new program, the nursing students may have had fewer concerns. 214 II. THB COLLEGK: A. Will there be « aufflcleat number of faculty prepared to teach In the proposed program? Criterion: At least two full-time faculty mem­ bers with a Ph.D. will be assigned to the graduate program and the faculty from the undergraduate program will Indicate a willingness to participate In teaching part-time at the graduate level. Obtaining the sufficient number of qualified faculty to teach at the graduate level was identified aa a top priority Item of concern among both nursing faculty and coilege-wide faculty. Qualified faculty members must be recruited to direct the program as well as to teach graduate level 'nurs­ ing courses. A faculty member with a Ph.D. has already been recruited with another department faculty member com­ pleting doctoral studies in August, 1986. Another five faculty members have begun their doctoral studies and are at various stages. The proposal for Che MSN program calls for the recruitment of additional doctorally prepared faculty members to teach at the graduate level. The fields of cur­ rent faculty members'’ doctoral studies are diverse. members are in education, Three two others are in nursing and another two are in human ecology. The fact that this college plans to develop a MSN program may attract addi­ tional qualified faculty into the department within the near future* 215 B. Is there a commitment on the part of the administration to provide necessary finances to support the program during planning and implementation? Criterion: The president and vice-president will agree to financially support the pro­ gram. As shown In Appendices V and W, the administrators of SVSC have been In full support of the development of a MSN program from the outset. The college plans to support the program financially to supplement a grant from the Depart­ ment of Health and Human Services each year for the first three project years. The college also plans to continue support of the program after the first three years. 216 C. Are existing clinical resources In nearby communities adequate to provide graduate level experiences? Criterion: The data will Include the nuaber of clinical agencies that will accoaio*’ date HSH students for clinical activities, qualified preceptors, and arena for nursing research. The Potential Employer Survey and Community Task ForceGroup discussions revealed that there are a sufficient number of clinical resources available to support the proposed program. The resources available Include: cllnlcaland/or research activities, an arena for and preceptors in various specialty areas on all levels of care. Potential Employer Survey revealed, responding, The of 36 agencies 19 indicated that they would provide the clinical sites, 15 agencies would have arenas for reserach activities and 11 agencies would have preceptors. A number of letters of support have been sent by the area health care agencies in support of the proposed program. Also, has been a growing interest among area hospitals there In nursing research. A variety of potential clinical sites such as schools, Industries, long-term health care agencies have not yet been tapped by the existing nursing programs. Some concerns, however, have been identified regarding the clinical practicum. One of the concerns identified during the Community and Alumni Task Force Group discussions 217 regarding the clinical resources Included: potential difficulties In Identifying the preceptors with appropriate qualifications. Careful selection of preceptors Is essential for the quality of practlcum experience of the graduate students. Another concern expressed by a member of the Alumni Task Force was that there may be a conflict of interests among the competing agencies when a student from one agency has graduate practlcum at another. Competition among area health care agencies is a new phenomena being experienced among competitive markets in the health care industry today. With increased efforts of the College to maintain good ■rapport with area health care agencies, we anticipate that a wealth of resources and opportunities will be made available to our students for their practlcum. 218 D. Is there another MSN program In the area similar to the one proposed by SVSC? Criterion: Indicate MSH programs located within the commuting distance from STSC and offer similar MSH program* As shown la Figure 4 In Chapter One, there are other graduate nursing programs within the state of Michigan, ever, how­ none of which Is located within 60 miles from SVSC* The program closest to Saginaw is 70 miles away at Michigan State University which focuses on primary care and geron­ tology clinical nurse specialist roles* Other colleges or universities which offer graduate degree in Nursing, e.g., the University of Michigan and Wayne State University are located outside of the commuting distance for the R.N.s employed in the SVSC area. 219 E. Are there sufficient csnpus facilities and learning resources to neet the needs of the proposed program? Criterion: Indicate additional facilities/ resources needed for a class of 15-20 graduate students/year: e.g., one classroom, microcomputers/research room, lounge area, two faculty offices, library books/journal for graduate studies. Saginaw Valley State College Is currently conducting a building program which will result In the completion of a new library, August, 1986. Instructional facilities, and office spaces in The college also plans to renovate Wicks Hall which will provide classrooms, laboratory and research facilities for the Department of Nursing. expected to be completed by August, The renovation is 1987. The Department of Nursing will acquire a newly designed learning laboratory of approximately 16,230 square feet, containing simulated clinical laboratory, learning laboratory, audiovisual and additional space to conduct nursing r esea rc h. The proposed program will be housed within the Depart­ ment of Nursing, where graduate students will have access to microcomputers and an interactive video system. The stu­ dents will also have access to main frame computers their data analysis. for The space reserved for the research area will include a one-way observation mirror for use in nursing research activities. The newly completed library will contain 66,766 square 220 feet of floor space, 240,000 volumes* ings seat 826 students, Currently, there are 624 periodical hold ­ Including 46 nursing periodicals. holds and accommodate The library also 111,000 volumes Including 3,027 health related volumes. These numbers of holdings are expected to increase as the new library opens In September, 1986. Interlibrary loan and on-line data base search are also available. Students also have access to Saginaw Cooperative Health Science Library which is centrally located to the five hospitals within the City of Saginaw. Students also have access they have practlcum to libraries in hospitals where experience. As described above, accommodate the proposed program in terms of space and learning resources. holdings the College will be able to Plans for obtaining additional library to meet the needs of graduate nursing students will be included in the program proposal. 221 F. What is Che process of obtaining approval from the college for the development of a new graduate program? What Is the pro— cedure of approval at the state level? Criterion: - Indicate the curriculum approval process at STSC. — Describe steps for a formal, statelevel approval mechanism. Steps for Approval of a Mew Graduate Program at S T S C : The curriculum proposal for the new program must first be approved by the Department of Nursing. then be sent to the Graduate Council. The proposal will The Graduate Council consists of two Academic Deans who have graduate programs, and seven faculty members representing each school, one graduate student, and the Vice President for Academic Affairs who serves as a chairperson. sibilities Include: program matters, The council's respon­ approval of all graduate curriculum and reviewing and adopting policies and pro­ cedures relating to the graduate programs in the College, and granting approval for faculty to teach graduate courses. After the approval of the curriculum proposal is granted by the Graduate Council, the proposal will then be submitted to the faculty for ratification. The proposal will then be submitted to the Board of Control for final approval. Steps for Approval of a New Graduate Program at State L e v e l : The proposal will first be presented to the Council of Academic Deans at the State level. The formal approval will then be granted by the Michigan State Board of Education. 222 6. How do other faculty In the college feel about the development of a HSH program? Criterion: — More than 502 of the faculty repre­ senting each of five schools of STSC will support the proposed program. - List major recommendations/concerns regarding the proposed program* As described in Chapter Four, the Campus-Wide Faculty Taslt Force selected from each school on campus were generally in favor of the proposed MSH program* Among major concerns expressed by the members during the task force meeting were availability of continued financial support, ness of the program, cost effective­ recruitment of qualified faculty members, and availability of cognate courses. The group stressed that the administration's commitment to the continued support during and after the three-year grant project period must be present. The Administration has been in support of the development of a MSN program since the first project application was submitted in 1981. commitment to the proposal are evident Their support and in the letters of support from the President as well as the Vice-President of Academic Affairs which was addressed to the Dean of the School of Nursing and Allied Health Sciences. The group's concern toward cost-effectiveness is a legit­ imate one in that it has a great implication for program plan­ ning, especially because the majority of the potential students are desiring part-time studies. Relatively smaller enrollments usually can be expected in a part-time graduate program. 223 The recruitment of qualified faculty members also has been a concern among other Task Force groups in this study. However, as the existing faculty members are making signi­ ficant progress in their doctoral programs and a new faculty with Ph.Ds. is to be on board as of September, 1986, the School of Nursing is much more optimistic toward this matter. The program proposal for the MSN program submitted to the Department of Health and Human Services included a list of graduate level cognate courses Identified in existing graduate programs across the campus from the School of Education, School of Business, Behavioral Sciences. and School of Arts and There are sufficient number of cog­ nate courses that can be made available to the MSN students without creating new courses. Described above are summary of the Task Force Group represented in the faculty members at SVSC. The purposive sampling procedure of the members of this Task Force does limit the generalizablllty of the opinions beyond this' group. However, the group was in general, toward the development of a MSN program. 224 supportive H. Are Che undergraduate nuralng faculty coiiltted to the development of a MSH program? Criterion: - All undergraduate faculty members In the Department of Hurslng will provide endorsement toward the proposed program In terms of letters of support. - Describe commitment In terms of Interest In teaching In the program. - List major concerns/suggestions provided by the group. The faculty of the Department of Nursing is generally In support of the proposed program, as evidenced by the letters recently sent to the Dean of the School. One of the faculty members, who is a doctoral candidate made an active commitment toward the proposed program by conducting this feasibility study. The newly hired doctoral faculty expressed a strong interest in teaching and coordi­ nating the proposed program. Other members of the faculty, who are at various stages of their doctoral studies, expressed a willingness to teach in the proposed program as they pursue their doctoral degrees. The Faculty Task Force meeting was held twice during winter semester, 1986. During these meetings, the members of the Department of Nursing were asked to share their con­ cerns and ideas for the proposed program. Among the concerns expressed by the members included an adequate number and qualification of the faculty for the MSN program and the extent of their involvement program during the planning stage. These two meetings vided the faculty members opportunities cerns and ideas. in the proposed to share their con­ The Dean's presence at these meetings 225 pro­ clarified some of their questions program. 226 regarding the proposed MSN III. POTENTIAL E M P L O Y E R S ; A. What are the attitudes of the poteutlal employers toward the graduate nursing education? Criterion: - At least 50Z of sample of the Poten­ tial Employer Survey will respond that they would employ the graduates from the proposed program* - List the type of support the employer will provide toward the program (e.g., clinical sites* arenas for research, preceptors and employment opportuni­ ties) • - List the type of Incentives/support they will provide to the employees who would go on to a MSH program (e.g., tuition reimbursement, promotion, and pay raises). As evident in the results of the Potential Employer Surveys and Community Task Force the health care agencies in the surrounding communities are interested in the graduate nursing education. They support the SVSC' b efforts to develop a MSN program. Of the thirty-five agencies that participated in the Potential Employer Survey, 74Z of them responded that they would employ the graduates of the proposed MSN program. More than 50Z of them responded that they would support their employee's effort to pursue their graduate education by way of tuition reinbursement, leave of absences or accommodating work schedules. The potential employers are also willing to provide support toward the proposed program. support Include: activities, clinical sites, Examples of such arenas for research future employment opportunities and preceptors. 227 The agencies are also willing to provide incentives to their employees for pursuing a MSH degree by way of job reassign­ ment to better suit the employee's background, promotion and/or pay raises. It should also'be noted, agencies, however, that there are some though they are in the minority, who are not willing to employ or not interested in MSN graduates. attitudes must be examined according and needs of each agency. 228 These to the characteristics B, Are Chere vacancies or unfilled positions that require MSN background? Criterion: There will be at least 15 vacant positions requiring MSN degrees. The Community Task Force Group identified that there were vacancies in a gerontological clinical nurse specialist position, and supervisory positions in the Community Health agencies, as of January, 1986. The potential survey in March, were three vacancies 1986 revealed that there for the director of nursing p o s i t i o n s , two vacancies for the nurse educator positions, vacancies and four for clinical nurse specialist positions within the 20 agencies responding. One home care corporation reported that there are two vacancies at the corporate-level for MSN prepared nurses. Described above are examples of positions vacant as of Winter-Spring, 1986. These positions may be left vacant until they can find appropriate Individuals or they may be filled sometimes with persons with less qualifications. It is evident from above that the employers are search­ ing for MSN prepared candidates 229 for selected positions. C. Would positions requiring a MSN degree be crested 1C there were appropriately prepared candidates to Clll then? Criterion: At least 50Z of the potential employers will Indicate their willingness to employ MSN graduates In the administra­ tive and clinical specialty positions. The Community Task Force Group reported that clinical nurse specialists are needed in various specialties even •though there are only a few such positions in the area. the Potential Employer Survey, In twelve out of thirty-five (34.3Z) agencies responded that they are willing to recruit master prepared registered nurses to a number of administra­ tive and clinical specialty positions. Among those agencies willing to employ MSN prepared nurses are primarily medium sized acute care hospitals, Visiting Nurses Association and Psychiatric Mental Health agencies. The low positive rate of response for this question is probably due to the relative inexperience of the agencies in utilizing MSN prepared nurses and this may have lead them not to commit themselves at this time. Small rural health care agencies may hesitate to answer a question such as this due to uncertain economic outlook. 230 D. What functional role would be needed the most: administrator, teacher or clinical specialist? Criterion: The functional role most in demand will be nurse administrator role. The Community Task Force and Potential Employer Survey revealed that the administrator role would be most in demand. The need for a nurse administrator with strong background In business and administration were emphasized during the Task Force meetings. The contrast is seen In the choice of functional roles between the Potential Employer Survey and the Registered Nurse Survey. In Registered Nursey Survey, the respondents" most preferred functional role was a clinical nurse specialist role. Whether or not the proposed program would concentrate on one functional role over another must be dealt with extreme caution. The definition of the "need" should be examined from the Individual students perspective as well as the societal perspective. issue in program implementation. 231 This is an Important E. Which clinical specialty is la aost need of a master prepared nurse? Criterion: The clinical specialty area nost in deaand will be aedical-surglcal nursing, and secondly, gerontologi­ cal specialty* The Potential Employer Survey revealed that MedicalSurgical and Gerontological nursing were Identified as two specialty areas that are needed the most. The Community Task Force Group identified administration and clinical specialties in medical-surgical nursing and maternal-child health nursing are in demand. The R e g i s t e r e d •Nurse Survey revealed that their choice of specialty is also medical-surgical nursing followed by parent-child health. The Nursing Student Survey revealed that they had almost equal preference to both medical-surgi­ cal and parent-child health nursing. contrary to the employer survey, Gerontology, on the was not among the most pre­ ferred area of specialties among both potential student groups. There are obvious differences of opinion between the potential employer and the potential students the choice of specialty, regarding especially gerontological nursing. Again this has important implications in program planning. 232 IV. COMMUNITY: A. What are the social Indicators of the surrounding community that would show the needs for services for MSN prepared nurses? Criterion: - Data will Include demographic characteristics of the population, socioeconomic and health related statistics relevant to the develop­ ment of a MSN program. - Data will Include the types of health problems that can be helped by the HSH prepared nurses. In Chapter IV, selected local, state and national social Indicators as related to the needs for MSN prepared nurses have been reviewed. The forecasting for the nurse manpower revealed a need for the registered nurses.with more advanced academic preparations i.e., BSNs and the registered nurses prepared at masters and doctoral levels. The description of social indicators, local level, light particularly at e.g., demographic characteristics, shed some to the type of health care services needed by the people of the surrounding communities. The County-Wide Community Needs Assessment conducted by the United Way Agency of Saginaw County in Fall, 1985 provided data extremely relevent to this feasibility study. The study described the demographic and socioeconomic characteristics and trends of Saginaw County and delineated health related issues or concerns of various segments of the commu ni ty . 233 The following characteristics of the community are of particular relevance to the domain of nursing: 1. Increasing percentage of older citizens. 2. Higher number of unemployment compared to other parts of the State and households with Income below the poverty level. 3. Minority constituting 20Z of the county population. Major health problems and concerns identified in the study that can be helped by the registered nurse at a masters level include: 1. Drug abuse, alcohol abuse and child abuse - neglect constituting the largest problem in the community. 2. Violence against elderly family members are increasing. 3. There Is a lack of health care ser­ vices outside the acute care hospital as follows: -- In-home skilled nursing care — Rehabilitation for crippling diseases — Health Information — Low cost health care — Birth control counseling for teenagers — Service for teenage mothers -- Health supervision of the m en­ tally retarded persons and disabled persons in the home setting It is obvious from these reports that many of the hospital health care needs of* the citizens have not been met and are in great demand in this community. types of health problems listed above, 234 Especially the since they take special knowledge and skills of advanced health profes­ sionals such as counseling and teaching of clients, con ­ sumers and health care personnel. Much interdisciplinary coordination and collaboration are needed to deal with the above problems. Resources and expertise of nursing are not utilized in this community to the extent that the well trained professional can provide. Definitely, there Is a place for MSN prepared nurses in this community to help solve these major health problems and to promote health and well-being of the citizens. 235 B. What are the opinions of the coananlty representatives regarding the proposed program? Criterion: More than SOZ of the community representatives will agree that the proposed program would bene** fit the snrronnding community. The Community Task Force that represented the various segments of the community provided much input and support for this study. Included in the Task Force were; sentative of consumers, Education Center, a repre­ a director of an Area Health a hospital administrator, directors of nursing from acute care hospitals as well as from community health agencies, representatives from the local medical association and nurses' association. These people agreed that this community can be benefited by the services that master prepared registered nurses can provide. opportunities program. They have listed examples of employment that can be filled by the graduates of the MSN Among the concerns listed by this group included: the recruitment of qualified faculty and the manner the program would be offered. Above all, the opinions of this group were positive toward the proposed program. More thorough discussions of the opinions of the community representatives have been described in Chapter IV (pp. 236 131— 143). THE PRIMARY RESEARCH QPKSTIOH: Are there Substantial Needs and Resources for the Development of a MSN pro­ gram at SVSC? Criterion: Answers to all the subsidiary questions, 1) demonstrates a need forthe develop­ ment of a MSN program, and 2) Insure availability of sufficient amount of fiscal and moral support. As Is evident In the preceding discussions a substantial a amount of needs and resources do exist as identified by each of the constituent groups. Overall needs as well as the feasibility for the development of the proposed program, determined after careful examination of the identified byall of these groups. The however, must be needs and resources definition of the needs, whether they are the wants or actual needs; whether they are individual needs or institutional or societal needs, also be considered. respondent"s should It should also be kept in mind that the Interests and decision to be enrolled in the MSN program may change over time. Although there are some concerns and issues sidered, to be con­ the results of three data collection methods used in this study revealed that there are substantial needs for ji MSN program in the a r e a . There is a sufficient pool of BSNs for continued enrollment, as well as community and college resources to support the program. 237 PART I I : PRIMARY RESEARCH QPKSTIOH How well was Che study conducted? The following subsidiary questions will be addressed in terms of the degree to which the needs assessment met the criteria of evaluation prepared by the Joint Committee on Standards for Educational Evaluation. The areas of devia­ tion from the standards will be discussed. The Issues conducting the needs assessment will also be Included. 233 for I. Has the Information reported appropriately? Criterion: A. 3. C. D. B. F. G* H. Discuss appropriateness of the report in terns of eight utility standards as follows: Audience Identification Evaluator credibility Information scope and selection Talnatlonal interpretation Report clarity Report dissemination Report - timeliness Evaluation Impact The utility standards are Intended to Insure that an evaluation will serve the practical given audiences* information needs of the The discussion of the evaluation of each standard follows* A* Audience Identification: Audiences Involved in or affected by the needs assessment should be identified so that their needs can be addressed. The audiences for the needs assessment persons who will use the needs assessment Include those to make decisions. The audience for this needs assessment Include: the Dean of the School of Nursing and Allied Health Sciences, and Administrator of the College, students and their employers. legislators, faculty potential These audiences were addressed as constituent groups in this needs assessment. The model used to conduct this study lent itself to the identification of all these groups as audiences of this study. Particularly, the use of the Task Force Method which called for the identification of as many alternative audi­ ences as possible, addressed this standard. 239 4 B. Evaluator C r e d i b i l i t y ; Those conducting the needs assessment should be trustworthy and competent to perform the needs assess­ ment, so that their findings achieve maxi­ mum credibility and acceptance. The researcher is a faculty member of the Department Nursing who has been on staff for the past five years. has recently been granted tenure. years, ever, She During the past five she has conducted three research studies. previous experience of She has no in conducting a needs assessment. How­ she completed course work at the doctoral-level in Adult and Continuing Education, which included three doctoral-^level research courses one of which covered survey methodology. She conducted an extensive review of the literature on needs assessment. tered nurse with The researcher is a regis­ 17 years of clinical experience and a Masters of Science in Nursing. Because of her credibility as described above, the Dean of the School of Nursing and Allied Health Sciences entrusted this researcher to conduct this study. One of the limitations of this study, however, the study was entirely entrusted to one researcher. was that A team of faculty members conducting the Btudy may have increased the credibility of the study. However, such an endeavor would have Increased the complexity and expense of the s tudy• 240 C. Information Scope and S e l ec ti on : Informa­ tion collected should be of such scope and selected in such ways as to address perti­ nent questions about the object of the needs assessment and be responsive to the needs and interests of specified audiences. To have the appropriate scope of information, the needs assessment must be relevant to decision-makers objectives, Important to significant audiences, and sufficiently compre­ hensive to support a judgement of worth (The Joint Committee on Standards for Educational Evaluation, 1981). Most infor­ mation of the needs assessment are of concern to multiple audiences. of different Each audience can be expected to raise a number Issues concerning the development of a MSN pro­ gram. The use of the Nominal Group Process in the task force group meetings provided a wide scope of information, and served as a basis for the development of the survey ques­ tionnaires. Therefore, the Information collected in this study was intended to be comprehensive, amount of data. immediately, producing a large Some of the data collected are not needed but will be helpful for further planning of the program. Because the study produced a large amount of data, appropriate elements must be organized and selected for reporting to appropriate audiences. 241 the D. Valuations! Interpr et at i on : The tives, procedures, and rationale interpret the findings should be described, so that the bases for judgements are clear. perspec­ used to clearly value Judgement as to whether or not it is feasible to develop a MSN program depends on how information is gathered and interpreted. The interpretation should be based on rationale that are understandable to everyone concerned. The primary Issue in interpreting the needs assessment information is to define what is meant by "needs". The determination of needs must be based on both indi­ vidual and societal needs. The model applied to conduct this study took this into account. The need for the pro­ posed program were viewed from both potential students and employers perspectives. Whether or not such a program is needed was also examined through the perspective of the surrounding community. Several areas of this report address this issue. E. Report C l a r i t y : The needs assessment report should describe the group whose needs are being evaluated and its loca­ tion, and the purposes, procedures, and findings of the needs assessment, so that the audiences will readily under­ stand what was done, why it was done, what Information was obtained, what con­ clusions were drawn, and what recommen­ dations were made. The report should be written with clarity and written appropriately in scope for the Intended audiences. in this context refers to explicit and unencumbered 242 Clarity narrative, illustrations, and descriptions. characterized by conciseness, defined technical terms, It is also logical development, well tabular or graphic representation and relevant examples. In preparation of this report, clarity of the content and organization were reviewed by individuals ence in writing technical reports. having experi­ Tables were used as little as possible and the data were incorporated within the text. The figures were used in some areas to Illustrate the points further. However, this report falls short of con­ ciseness because of the extent of the data generated. more concise A report explaining the essence of the results will be prepared to disseminate to the appropriate audi­ ences . F. Report D is s e m i n a t i o n : Needs assessment findings should be disseminated to clients and other right-to-know audiences, so that they can access and use the findings. Dissemination here refers to the actions - such as written, oral, and audio-visual reporting - of the study findings to all right-to-know audiences (The Joint Com­ mittee on Standards for Educational Evaluation, 1981). right-to-know audience is the one that Is entitled to be Informed about the results of the needs assessment, subjects of the surveys, task force members, e.g., college com­ munity and health care agencies of the area studied. concise report A A is now being planned to be disseminated to these audiences. In the proposal 243 the dissemination of the report was being provided for by asking the respondents to separately send a card with their name and address continued communication for those who wished. design lacks, however, a precise The research plan for the dissemination of the report to each of the intended G. for audiences. Report Timeliness; Release of reports should be timely, so that audiences can best use the reported information. The reports are timely when they are delivered to each audience at a time when they can best use the report infor- tion (The Joint Committee on Standards Evaluation, 1981). for Educational The timely report will be made when the time table Is built Into the Initial proposal. It is also important to check the progress at intermediate points to inform the clients about possible delays that may cause the reports to be late. In preparation of the grant proposal for SVSC, the information from this study was needed by the Dean of the School of Nursing and Allied Health Sciences at the beginning of June. underestimated, The time needed for data analysis was therefore, the complete Information was made available to the Dean a week to ten days late. The Dean was still able to prepare the grant proposal with the findings from the needs assessment. However, a more realistic time­ line and spending less time analyzing the data may have resulted in a more timely report. 244 H. I«pir-____ APPENDIX D: DOCUMENTS CONCERNING PROTECTION OF HUMAN SUBJECTS - MICHIGAN STATE UNIVERSITY APPENDIX D MICHIGAN STATE UNIVERSITY UNTVER5ITY COMKTITEE ON RESEARCH INVOLVING HUMAN SUBJECTS (UCR1H5) 131 ADMINISTRATION BUDDING EAST LANSING • MICHIGAN • 4U14.IM6 (J17) 3IJ-21IS February 21t 1986 Ms. Sachiko K. Claus 3207 Curtis Road Birch Run, Michigan 48415 Dear Ms. Claus: Subject: _______ Proposal Entitled, "An Analysis of the Process of Conducting a Needs Assessment for a MSN Program at SVSC"_______________ : _________ I am pleased to advise that I concur with your evaluation that this project is exempt from full UCRIHS review, and approval is herewith _ granted for conduct of the project. You are reminded that UCRIHS approval is valid for one calendar year. If you plan to continue this project beyond-one year, please make provisions for obtaining appropriate UCRIHS approval prior to February 21, 1987. Any changes in procedures involving human subjects must be reviewed by the UCRIHS prior to initiation of the change. UCRIHS must also be notified promptly of any problems (unexpected side effects, complaints, etc.) involving human subjects during the course of the work. Thank you for bringing this project to my attention. future help, please do not hesitate to let me know. Sincerely, Henry E. Bredeck Chairman, UCRIHS HEB/jms cc; Dr. James E. Snoddy 295 AtSUis am Affirmative Aition/EqtmlOpportunity tmtitutinn If I can be'of any 3207 Curtis Road Birch Run, HI 48415 February 19, 1986 Dr. Henry Bredeek Administration Building Room 234 Michigan State University East Lansing, MI 48824 Dear Dr. Bredeelct I am enclosing three letters that are to accompany the questionnaires. Your suggestions have been incorporated in these letters. I appreciate your suggestions. Sincerely, Sachiko K. Claus Doctoral Student SKC/tlf Enclosure TO: FROM: Sachiko K. Claus, Doctoral Student Department of Administration and Curriculum Adult and Continuing Education Michigan State University Home Address: RE: DATE: 3207 Curtis Road Birch Run, Ml 48415 Review of Projects Involving Human Subjects: Full Committee Review A Request for Exemption from February 11, 1986 I am requesting the committee to review my which involveshumansubjects. The attached mation specified bythe review committee. meets the criteria for the category of 1-C Full Committee Review." doctoral dissertation project document includes the infor­ 1 believe that the project and E under "Exemption from Therefore, I am requesting that the status of "Exemption from Full Commit­ tee Review" be applied to my project. The following describes title and the rationale for meeting the criteria for the exemption: Title: An Analysis of the Process of Conducting a Needs Assess­ ment for a MSN Program at SVSC Rationale: A. B. The project involves two types of surveys: The survey of potential employers and the survey of potential students. 1. The questionnaires are designed and admin­ istered so that the potential students and potential employers cannot be identified either directly or indirectly via identi­ fiers. 2. Risks involving the subjects are considered minimal. The project also is planned to use the existing data which are publicly available, e.g., demo­ graphic data, health indices, employment trends. 297 A REQUEST FOR THE REV I E W OF PROJECTS INVOLVING HUMAN SUBJECTS 1. Abstract: 2. The requirements for a subject population and the rationale for using the particular population group. A. B. Please see Exhibit A. The survey of the potential students 1. The survey of the potential students would be essential for successful program development. In this study, those who meet the criteria for the proposed MSN program are the regis­ tered nurses who have a Bachelor’s Degree in Nursing (BSN) or who anticipate a BSN degree in the near future. Cur­ rently no such listing of the BSN population in the study area is available. 2. The potential students (BSNs and potential BSNs) can be identified relatively easily through their employment. 3. In order to identify the subjects in the sample institution, the Director of Nursing will be asked to provide the number of BSNs and potential BSNs in the agency. 4. The currently enrolled nursing students will also be asked to participate in the survey since this population could benefit from the proposed MSN program. Survey of the potential employers The potential employers will be identified from the list of health care agencies provided by the Michigan Department of Public Health. This sampling frame was used for sampling the potential employers since the proposed program intends to meet the needs of the immedi­ ate surrounding area. 3. An analysis of the risk/benefit ratio. A. Potential risks; The voluntary nature of the survey and the procedure used to main­ tain subjects' anonymity will present minimal risk to the partici­ pating agency or subjects. B. Procedures i 1. The institutional and registered nurse surveys: The agency survey questionnaires will be mailed to the subject agency along with the registered nurses' questionnaire. The investigator will explain, either by phone or in person about the purpose and nature of the study to the directors of nursing education. They will be asked to distribute and retrieve the 298 questionnaires to/from the registered nurses who meet the criteria. The subjects will be asked to place their ques­ tionnaires in a sealed envelope before they are submitted to the inservice director. The Director of Nursing or his/her designee will be asked to complete the Institu­ tional Questionnaire and to return by mail. 2. The generic nursing student survey: During the second week of March the currently enrolled generic nursing students will receive a questionnaire from their course instructor. They will be asked to take approxi­ mately ten minutes at the beginning of the class to complete the questionnaire. The course instructor will be asked to collect the questionnaires immediately after their comple­ tion. 3. C. The subjects will be asked not toidentify themselves on the questionnaire. The subjects will be assured that the ques­ tionnaires will not be identified with the particular agen­ cies where the subjects are employed. Potential benefits; This needs assessment study would provide the college administrators with realistic information for decision-making and eventually for the development of a MSN program. The establishment of a successful MSN program at SVSC would provide the area registered nurses with an opportunity to undertake graduate level nursing studies closer to their home and work place. The development of high quality graduate nursing program would in turn elevate the scholarship of the SVSC School of Nursing and Allied Health Sciences. 4. Consent procedure. Informed consent will be obtained from the subjects at the time of distri­ bution of the questionnaires. The cover letter explains the purpose of the study will accompany the questionnaire. The subjects will be told that their participation in the survey is voluntary and that the decision not to participate will not in any way affect their relationship with the college. The agencies will be assured that their participation or non-participation in the survey will not affect their relationship between the agency and SVSC. The registered nurses will be assured that their participation or non­ participation in the survey will not affect their relationship with the inservice director or their performance evaluation. The nursing students also will be assured that their participation or refusal to participate will not in any way affect their grades. 299 5. Copies of consent forms. A cover letter that accompanies each questionnaire explains the volun­ tary nature of the survey as well as the procedure for ensuring anony­ mity. (Appendix B) 6. Copies of gathering instruments. Please see Appendix B. formed. Three types of survey questionnaires will be 7. Signed statement from the student's major professor. (Appendix C) 8. Graduate students to submit a "method" chapter of the dissertation. Please see Appendix D. This request particularly pertains to pages 4649. 9. The date the responses are requested: The date the survey will begin: March 1, 1986. March 2, 1986. 300 APPENDIX E: STEPS FOR ESTIMATING SAMPLE SIZE FOR THE REGISTERED NURSE SURVEY APPENDIX E To Estimate Appropriate Sample Size: Table E.l below shows the steps to estimate the overall sample size L and the number of clusters to be sampled for each type of health care agency. 301 TABLE E.l. STEPS FOR DERIVING NUHBER OF CLUSTERS IN EACH STRATUM. STRATUM Health D e p t ./ Visiting Nurses Assoc. (HD/VNA) Steps Step 1 Step 2 302 Step 3 Step 4 ni # agencies “i local avg Mi ** n.m, £ M 1 = 815.5 wi - Mi Home Care (HC) MediumSize Hospital (MH) 3(10) 7(6) .5 40 11x9 » 99 6.5 .12 .01 11(5*,6) 9 SmallSize Hospital (SH) Nursing Homes (NH) Schools of Nursing 13(18) 2(3) 5 .1 14.6 520 115 3 73 .64 .14 2(21) .004 .09 iMi Step 5 Step 6, 7 & 8 Overall for­ mula for L Mi - Hi .6 Insert values into overall formula as described in the narrative below. 268 x 12 .6 268 x .01 .6 268 x .64 .6 268 x .14 .6 ■ 6(3*,3) - 9(2*,7) - 7(4,3*) - 12*(1,11) *30 Mile Radius, 30-50 Mile Radius 268 x .004 .6 - 17(7,10) 268 x .09 .6 - 3(1,2) A verbal explanation of the steps used In estimating sample size as defined In Table E.l follows: Step 1. The total number of agencies for each type of health care agency was Identified by r e f e r -ing to the list provided by the Michigan Department of Public Health as of January, 1985. Step 2. By telephoning a sample of health care agencies In the area, the aver­ age number of BSNs employed by each type of health care agency was deter­ mined,^. Step 3. The total number of BSNs In each type of health care agency M. derived by m u l t i p l y i n g ^ ^ and Step A. W., a probability of proportion to size for each type of health care agency was determined by: Wi " Step 5. • * 42 The sample size L, then can be calculated as follows: - (99)2 1 U1 Mi (.25) + (6 .5)2 -- :t2-- (.25) + (520)2 -- nn (.25) r&4--- w 1 + (115)2 (.25) + (3)Z (.25) + (73)2 ( .25) rn Toos .09 - 20418.75 + 1056 + 105625 + 23616.07 + 562.5 + 14802.78 - 166081.35 (* m ±)2 (b2) + •6tz 4 - (816.5)2 (.05)2 + 99(.25) + 6.5(.25) + 4 520( .25) + 115 ( .25) + 3(.25) + 73(.25) - 416.67 + 24.75 + 1.63 + 130 + 28.75 + .75 + 18.25 303 620.8 166081.35 - 267.52 620.8 - 26 8 By this formula, the minimum number of the respondents needed for this survey was determined as 268. Step 6. The number of clusters to be sampled from each type of health care agency were derived by multiplying L and , Step 7. The questionnaire return rate for this survey was estimated as 60%. To ensure the minimum number of respondents (268), the number of clusters was divided by .6 to arrive at the final value (Table E.l). Step 8. The clusters chosen among the agen­ cies within 30 miles and 50 miles are proportionate to the actual number present. 304 APPENDIX F: HORSING EDOCATION SURVEY APPENDIX F NURSING EDUCATION SURVEY fora Proposed Masters Degree Program in Nursing (For Potential Students) Saginaw Valley State College School of Nursing and Allied Health Sciences March 1986 305 NURSING EDUCATION SURVEY fora Proposed Masters Degree Program in Nursing (For Potential Students) SAGINAW VALLEY STATE COLLEGE Please check the appropriate blanks unless otherwise instructed. Professional Nursing Background: 1. How many years have you been in practice as a registered nurse? □ A. Less than 1 year □ B. 2 4 years □ C 5-10 years □ D. 11-15 years □ E. 16-25 years 0 F. more than 25 years 2. In what type of setting are you currently employed? □ A. Hospital 0 B. Community Health Agency 0 C. Home Care Agency 0 D. Long-term Care Agency 0 E. Industry □ F. H.M.O. 0 G. Other: Please 3. What is your current position in your employment setting? 0 A. Staff/charge nurse 0 B. Head Nurse 0 C. Patient care coordinator/manager/supervisor 0 D. Assistant Director of Nursing 0 E. Director of Nursing 0 F. Nurse Educator (Inservice, Hospital Education) 0 G. Other: Please cjw-ify 4. What is your clinical specialty area? 0 A. Adult Medical-surgical 0 B. Critical care/O.R./Emergency 0 C. Parent-child Health 0 D. Community Health 0 E. Psych/mental Health 0 F, Gerontology 0 G. Occupational Health 0 H . Other, Please gp»Hfy 306 Educational Background 5. What isthe type and year of your initialnursing Education? Year Earned □ A. Diploma □ B. Associate Degree . O C- Bachelors Degree in nursing 6- What is the highest degree you hold? □ A. Diploma Q B. Associate Degree □ C. B.S. in Nursing □ D. Bachelors degree in other field (specify — * 0 E. M.S. in Nursing r_l F Mnst^rv degree in other field fgp«r4fy ) 0 G. Ph.D. in Nursing or DNsc 0 H . Ph.D. in orhpr fwlrf (gjwHfy ) □ I. Other: Please g p ^ fy 7. Are you currently enrolled in any of the following educational programs? □ A. B.S.N. program 0 B. Bachelors in other field (specify fioM ) 0 C. M.S.N. program 0 D. Masters in other field (specify f,'olrl ) 0 E. Ph.D. in Nursing or DNsc 0 F. Ph.D. in other field (specify fio1H > Future Educational Plans 8. Do you plan to be enrolled in any of the following academic programs within the next three years? 0 A. B.S.N. program 0 B. Bachelors in other field (specify f{n|H ]> 0 C. M.S.N. program 0 D. Masters in other field (gp«nfyfinirt ) 0 E. Ph.D. in Nursing or DNsc 0 F. Ph.D. in other field (specify ) 0 G. Other (gp°^fy ) Proposed MSN program a t SVSC; When a Masters degree in nursing program is developed at SVSC, the program will be 40-46 credits to complete. The major qualifications for admission to the program are projected as follows: ■Baccalaureate degree in nursing from a N.L.N. accredited insitution ■Undergraduate G.PA. of 3.0 or higher (on a 4.0 point scale) • Licese to practice as a registered nurse in the State of Michigan ■Documented competence in nursing practice through references 307 9. Do you have all of above qualifications? □ A. Yes, currently □ B. Not yet, but expect to have within next 2*3 years □ C. No, not within next 2*3 years 10. Would you enroll in the masters degree program in nursing if it were available at SVSC within the next 2*3 years? □ A. Yes, definitely □ B. Yes, maybe Q C. No, I plan to be enrolled in a MS.N. program elsewhere O D* No, I do not plan to go on to a M.S.N. program O E. Other (please ) If you answered “Yes, definitely,” or “Yes, Maybe” in the above question (#10), please answer questions #11 through #22 If you answered “ No”, answer #17 through #22 11. What specialty area would you choose to study in the MSN program? G A. Community Health □ B. Psych-mental Health Q C. Parent-child Health □ D. Gerontology □ E. Adult Med/surg □ F. Other: please cpw.ty 12. What functional role are you interested in teaming in the MSN program? □ A. Nursing administrator role □ B. Nurse Educator role G C. Clinical Nurse Specialist role □ D. Nurse researcher role □ E. Other: please cp<*Hfy 13. When you are to be enrolled in the proposed Masters degree in Nursing program, you will enroll: □ A. Full-time G B. Part-time 14. When you are to begin the proposed masters degree program, would you prefer to be enrolled in: G A. Fall and Winter semesters only G B. Fall, Winter, Spring and Summer semesters G C .O ther:pleasespecify— .. ... , , .. ■_ 308 15. Which of the following days of the week are most convenient for you to commute to SVSC? □ A. Two afternoons per week (week days, each 3 hours) □ B. Two evenings per week (week days, each 3 hours) □ C. One day a week (week day, each 6 hours) □ D. Every other Friday and Saturday (12 hours Bi-weekly) □ E. Other: please specify 16. From your residence, how far would you need to travel to SVSC? □ A. up to 20 miles □ B. 21 -30 mUes □ C. 31 - 40 miles 0 D. 41 - 50 miles 0 E. more than 50 miles Demographic Background 17. Sex 0 A. Male 0 B. Female 18. Age: 0 A. 18 - 25 0 B. 26 - 35 0 C. 36 - 45 0 D. 46 - 55 0 E. over 55 19. Race: 0 A. White 0 B. Black 0 C. Spanish 0 D. American Indian 0 E. Oriental 0 F. Other (specify_____________________________________________________________ ) 20. Marital Status: 0 A. Single 0 B. Married 0 C. Divorced 0 D. Separated 0 E. Widowed 309 21. Number of Dependents: □ A. None □ B. 1 □ C. 2 □ D .3 □ E .4 □ F. S or more 22. Ages of Your Dependents: Q A .______years old □ B .______years old □ C .______years old □ D .______years old Q E. years old 23. What would be your objective for enrolling in the proposed M.S.N. program? 24. Please write questions and comments about the proposed program. 310 For further inquiry about the proposed masters degree program, or for this survey please contact; School of Nursing and Allied Health Sciences Saginaw Valley State College 2250 Pierce Road University Center, MI 48710-0001 Telephone: 517-7904145 **Thank you!** A P P E N D IX G: LETTER OF TRANSMITTAL TO REGISTERED NORSES APPENDIX G Saginaw Valley State College Dear Registered Nurse: The School of Nursing and Allied Health Sciences, Saginaw Valley State College is preparing an application to Health and Human Services. The purpose is to procure funding in order to plan, develop and operate a high quality graduate nursing program at SVSC.. The graduates will earn the Master of Science In Nursing degree and will be prepared for leadership roles in nursing practice and nursing educacion settings. As a part of the application for federal funding, we must Identify the poten­ tial students for the proposed program. Please complete the attached question naire, enclose it in the attached envelope, and return it to your supervisor within the next 5 to 7 days. We ask that you do not put your name on either the questionnaire or on the envelope. Your participaTion in the survey is voluntary, you may discontinue your participation at any time. Your partici­ pation or non-participation in the survey will not in any way affect your per­ formance evaluation, your relationship with the person distributing the ques­ tionnaires, nor your relation with Saginaw Valley State College. If you wish to be kept informed of any progress in getting the M.S.N. program started, please write your name and address on a separate card found with this questionnaire. Thank you for your time and interest. Sincerely yours, Crystal M. Lange, RN, PhD, FAAN Dean for the School of Nursing and Allied Health Sciences CML/tlf Attachments 312 University Center, Michigan 4 8 7 1 0 00 01 Phone (5 1 7 ) 7 9 0 - 4 0 0 0 or (517) 6 9 5 - 5 3 2 5 A P P E N D IX H : RETURN ENVELOPE AND POST CARD FOR SURVEYS NO POSTAGE NECESSARV IF MAILED IN THE UNITED STATES APPENDIX H BUSINESS REPLY MAIL FIRST CLASS PERM IT NO.931 SAGINAW, Ml POSTAGE WILL BE PAID BY ADDRESSEE Saginaw Valley State College School of Nursing Dr. Crystal M. Lange P.O. Box 2087 Saginaw, Michigan 4860S5S93 NO POSTAGE NECESSARY IP MAUD IN THE U N T O STATES BUSINESS REPLY MAIL G o a Psrmil N o. T31, S o g i iw , Ml fire Postage be poid by Addreeeee SAGINAW VALLEY STATE COLLEGE £MHOOI Offn o n B f Dr. CkYMl ftL Langi P.O. Boa 2 * 7 Saginaw, MI 4S6Q&MS3 NAME INSTITUTION ADDRESS STATE 2P PHONE 1 would like to be informed of p ra g m a in implementing on M.S.N. program at Saginaw Valley State College. YE5NOPlease list any questions you have regarding the proposed M.S.N. program. APPE N D I X I: COMMUNICATION WITH PARTICIPATING AGENCT APPENDIX I Saginaw Valley State College M arch 1 1 , 1 9 8 6 D r . H a r la n d V e r r i l l D e p a r tm e n t o f P a t h o l o g y H u r le y M e d ic a l C e n t e r , 1 H u r le y P l a z a , F l i n t , M ic h ig a n , 4 8 5 0 2 D e a r D r . Verrill: I am w r i t i n g i n r e g a r d s t o t h e q u e s t i o n n a i r e s w h ic h we w o u ld l i k e t o d i s t r i b u t e t o t h e r e g i s t e r e d n u r s e s i n H u r le y M e d ic a l C e n te r. The q u e s t i o n n a i r e i s d i r e c t e d t o t h e B a c c a l a u r e a t e P repared n u r s e s . I t i s a p a r t o f th e n eed s a sse ssm e n t stu d y f o r t h e p r o p o s e d M a s te r s D e g r e e P rogram i n N u r s in g a t S a g in a w V a lle y S ta te C o lle g e . I am r e q u e s t i n g a n e x e m p tio n fro m a f o r m a l r e v i e w b y t h e I n s t i t u t i o n a l R e v iew B o a r d s o f H u r le y M e d ic a l C e n t e r b e c a u s e o f th e fo llo w in g r e a so n s: 1 . The s u b j e c t s f o r t h i s s t u d y a r e n o t t h e p a t i e n t s o f H u r le y M e d ic a l C e n t e r . 2 . The s u b j e c t s ( t h e r e g i s t e r e d n u r s e s ) w i l l n o t b e i d e n t i f i e d b y t h e i r name o r w i t h a n y o t h e r c o d i n g s y s t e m . 3 . P a r t ic ip a t io n w ith t h i s su rv e y i s v o lu n ta r y . I am e n c l o s i n g a c o p y o f t h e r e q u e s t f o r t h e I n s t i t u t i o n a l B o a rd o f S a g in a w V a l l e y S t a t e C o l l e g e w i t h i t s a p p r o v a l . T h is d o cu m en t i n c l u d e s t h e p r o c e d u r e o f t h e s u r v e y a s w e l l t h e s a m p lin g p r o c e d u r e . A ls o in c lu d e d a r e an a b s t r a c t o f e n t i r e n e e d s a s s e s s m e n t o f w h ic h t h i s s u r v e y i s a p a r t . The r e g i s t e r e d n u r s e q u e s t i o n n a i r e and a c o v e r l e t t e r w i l l be fo u n d . Thank y o u f o r y o u r c o n s i d e r a t i o n t o e x a m in e t h i s d o c u m e n t. S a c h ik o K. C la u s R. N. M. S. A s s is ta n t P r o fe sso r D e p a r tm e n t o f N u r s in g 314 U niversity Center, Mtchinan 4 8 7 1 0 P h on e (5 1 7 ) 7 9 0 - 4 0 0 0 or (5 1 7 ) 6 9 5 - 5 3 2 5 R ev iew as th e a ls o HURLEY MEDK2L CENTER ONE HURLEY PLAZA.RNT.MCHGAN 48502 PHONE (313) 257-9000 March 28, 1986 Ms. Sachiko K. Claus, R.N., M.S. Assistant Professor Department of Nursing Saginaw Valley State College University Center, MI 48710 Dear Ms. Claus: Ihave reviewed your questionnaire involving the study of RN*s who have BSN. Since this does not involve Invasive or psychological manipulation, human risks are non­ existent. Iexercise my authority as chairman of the Institutional Review Board to exempt this study from review. This decision will be reviewed at the next meeting of the Hurley Medical Center Institutional Review Board* Thank you for consulting the Institutional Review Board with this project. Harland Verrill, Ph.D. Chairman Institutional Review Board HB:ntb:500 315 APPENDIX J: LETTERS TO DIRECTORS OF NURSING EXPLAINING THE PROCEDURES FOR THE REGISTERED NURSE SURVEY A PPENDIX J Saginaw Valley State College Dear Director of Nursing! As a part of our needs assessment for a proposed master's in nursing (MSN) program at SVSC we are asking BSN prepared nurses and those who are currently enrolled in the courses toward the BSN degree to respond to a questionnaire. The questionnaire ^nd the letter explaining the procedure for returning the questionnaire are included in this packet. Please ask each of your unit supervisors to identify the registered nurses who meet the criteria for this survey. The criteria are; (1) BSN, or (2) R.N. who is currently enrolled in the courses toward BSN degree Please ask the supervisor to distribute the questionnaires to those who meet the above criteria and then collect the questionnaires within the next 7-10 days. After the questionnaires are collected, please deposit them in the mail. We greatly appreciate your assistance with our needs assessment. Should you have any questions regarding the questionnaire administration, please contact! Crystal M. Lange (517) 790-4145 or Sachiko K. Claus (517) 790-4129 (office) (517) 777-2584 (home) Sincerely, Dean, School of Nursing and Allied Health Sciences nkr Enclosures 316 University Center. Michigan 48710 Phone (517) 790-4000 or (517) 695-5325 APPENDIX K: NUMBER OF QUESTIONNAIRES DISTRIBUTED/ RETURNED . If a MSN is required or preferred for any of the nursing positions, please check [7] whether or not those positions are vacant. If vacant, please indicate the number of vacancies beside the appropriate position below: Vacant Filled # Vacant Position n □ — — A. Vice President, Nursing _ B. Director of Nursing □ [_] _ C, Assistant Director of Nursing □ □ D. Director of Nursing Education, Hospital Education nr Staff Development □ Q _ _ _ _ _ E. Coordinator^ Nurse Specialist □ Q ________ - F. Clinical Nurse Specialist □ □ - G. Coordinator/Manager/Supervisor, Patient Care □ Q H. Head Nurse □ Q I. Charge/Primary Nurse □ □ J. Other (please specify) . . □ □ _ _ _ _ _ K. 0 ther (please specify)....... □ □ _ _ _ _ _ L. Other (please specify) — 6. If a MSN is not required for any of the current positions, is there any plan to recruit a MSN prepared nurse, provided any vacancy occurs in the near future in the positions listed in ques­ tion #4. (Check one) □ A. Yes □ B. No 7. Which of the following positions can a BSN with a master’s degree in another field (other than nursing) satisfy the qualifications in your agency? (Check as many as apply) □ A. Vice President, Nursing □ B. Director of Nursing □ C. Assistant Director of Nursing □ D. Director of Nursing Education/Staff Development G E. Director of Hospital Education □ F. Coordinator/Manager/Supervisor, Patient Care Continuedonnextpage 328 □ G. Head Nurse □ H. Charge Nurse/Primaiy Nurse □ I. Other (please specify)-----------□J.Other(pleasespecify) □ K.Other(pleasespecify)----------Comments: .. 8. Which clinical specialty for MSNs would meet the needs of your agency? (Check as many as apply) □ A. Adult-Medical Surgical □ B. Health Care for Women □ C. Pediatric/Child Health 0 D. Community Health/Home Care 0 E. Psychiatric/Mental Health 0 F. Industrial/Occupational Health 0 G. Gerontological 0 H. Other (please specify)----------------------------------------0 1. Other (please specify) ______ ■ 0 J . Other (please specify) 9. If you plan to employ MSN graduates, what functional roles will be needed?!Check as many as apply) 0 A. Nursing Administrators 0 B. Nurse Educator 0 C. Clinical Nurse Specialist 0 D. Nurse Researcher 0 E. Other (please specify) . . . ........................................... ..... 0 F. Other (please specify) ............. 0 G. Other (please cpwify) 10. If the proposed program were to provide a major in nursing administration, which of the follow­ ing topics are important in your agency? Please rank the following topics according to the im­ portance in your agency. (1 being the most important, 2 being the second most important, etc.) Rank A. Management Information Systems B. Health Care Financing and Management C. Personnel Management D. Legal and Ethical Aspects of Health Care E. Nursing Leadership F. Labor Relations G-Marketing Continued 329 onnextpage H. Entrepreneurship (Health Care Related) I. Long-Term Care Administration J. Research K . n th & W p lp g c g g jw -ify l 11. If your employee decided to go on for a MSN degree, would you be willing to provide any of the following support? (Check as many as apply) □ A. Tuition Reimbursement: Maximum Amount of $ /year □ B. Scholarships: Maximum Amount of $ 0 C. Accommodate Work Schedules 0 D. Leave of Absence 0 E. Other 0 I-'. None 12 If your employee earns a MSN degree while employed in your agency, what type of incentives u ouM in* provided by the agency? (Check as many as apply) Lj A. I’ay Raise 0 B. Promotion to a Higher Position 0 C. Job Reassignment to Better Suit the Employee's Educational Background 0 D . Other (please specify)----------------------------------------------------------------------------------0 E. None 1 13. If SVSC begins a MSN program, what type of resources would be available in your agency to help support such a program? (Check as many as apply) 0 A. Clinical Sites 0 B. Arena for Research Activities 0 C. Potential Students 0 D. Future Employment Opportunities 0 E. Preceptors 0 F. Other (please specify) — ^ Comments: _ 14. Would your agency be willing to employ the graduates of the proposed MSN program? (Check one) 0 A.. Yes 0 B. No Comments: - ....................... 330 15. In which of the following categories would your agency be classified? (Check as many as apply) □ A. Industry □ B. Long-Term Care Facility □ C. Home Care Agency □ D. VNA or Community Health Agency □ E. Acute Care Hospital (bed capacity over 150) □ F. Acute Care Hospital (bed capacity less than 150) □ G. Rehabilitation Hospital □ H. Other (please specify I---------------------------------------------------------------------------------16. What comments or questions, if any, regarding the proposed program do you have? (If you would like us to respond to your questions please write them down on the attached post card.) Thank you for your participation. Please return this questionnaire along with the registered nurse survey and mail them to: The School of Nursing and Allied Health Sciences Saginaw Valley State College 2250 Pierce Road University Center, MI 48710 In order to maintain your agency’s anonymity, please do not identify your agency name. If you wish to be informed of the results of the survey as well as the status of our proposed MSN program, please complete the attached post card and mail separately to the above address. 331 APPENDIX P: LETTER OF TRANSMITTAL TO DIRECTOR OF NURSING A PP ENDIX P t>«l3 Saginaw Valley State College Dear Director of Nursingt • The School of Nursing and A'llied Health Sciences at SVSC Is proposing a Masters of Science Degree in Nursing Program. The school intends to submit a grant application to the Department of Health and Human Services prior to July 1, 1986. Ve anticipate the earliest possible dace for the program implementation to be in Fall, 1987 or Winter, 1988. The type of program we will offer depends greatly on the identified community needs. In December, 1985, the school began a feasibility study for the proposed program. As a part of the needs assessment we would like to survey the area institutions for your input. Your participation in the needs assess­ ment process is very crucial to the kind of program we will provide. Please answer the questionnaire, enclose it in the self-addressed envelope, and mail it to the address indicated. Please do not identify the agency name, nor the name of the person completing the questionnaire. Participation in the survey is voluntary. Your agency's participation or non-participation in the survey will not in any way affect your relation­ ship with Saginaw Valley State College. If you would like to be kept informed of the progress in regards to the MSN program, please fill out the separate post card. Also please write down any questions regarding the proposed program on the post card. Sincerely yours, Crystal n. L>ange, rnu, tflwi Dean, School of Nursing and Allied Health Sciences Saginaw Valley State College 2250 Pierce Road University Center, MI 48710 332 University Center, Michigan 4 8 7 1 0 - 0 0 0 1 Phone {517} 7 9 0 - 4 0 0 0 or (5 1 7 ) 6 9 5 - 5 3 2 5 APPENDIX Q: EVALUATION FORM FOR THE DEAN APPENDIX Q E v a lu a t io n P r o c e s s and Outcome o f t h e F e a s i b i l i t y S tu d y For M a s te r s D e g r e e P rogram i n N u r s in g 5 4 3 2 1 Strongly agree agree neutral disagree strongly disagree Has t h e s tu d y -m e t t h e o b j e c t i v e o f t h e d e c i s i o n m ak ers ? 5 4 3 2 1 a . The amount and q u a l i t y o f in f o r m a t io n a d e q u a te ? 5 U 3 2 1 5 3 2 1 5 3 2 1 a . t h e d e s i g n o f t h e s t u d y a cco m o d a te d f o r in v o lv e m e n t o f a w id e v a r i e t y o f c o n s titu e n t groups ? 5 4 3 2 1 b . t h e m eth od u s e d f a c i l i t a t e d t h e c o l l e c t i o n o f a l a r g e am ount o f d a t a w i t h i n t h e l i m i t e d am ount o f t im e ? 5r 3: 2:1 1. c . a c o m p le te p r o p o s a l p r e p a r e d p r i o r t o t h e b e g in n in g o f t h e s t u d y ? 5 4 3 2 1 d. c o st e ffe c tiv e 5 4 3 2 1 b . The r e s u l t s o f t h e s t u d y com m u n icated i n w r i t i n g c l e a r l y ? c . Was r e p o r t t i m e l y f o r u s e by t h e d e c i s i o n m aker ? 2 . Were t h e m e t h o d o lo g ie s e f f i c i e n t f o r o b t a i n i n g n e e d e d in f o r m a t io n ? ? e . A p p r o p r ia te s t a t i s t i c a l m eth od ? S a m p lin g ! D a ta A n a l y s i s ) 5 5 ^ ^ 3 3 2 2 1 1 f . k e p t t h e d e c i s i o n m aker in fo r m e d o f th e p r o g r ess ? 5 4 3 2 1 g . S o u g h t o p i n io n s o f o t h e r s f o r im p rovem en t o f t h e a p p ro a c h ? 5 4 3 2 1 h . Sought a s s is t a n c e o f needed e x p e r t i s e a t a p p r o p r ia t e tim e ? 5 4 3 2 1 333 Evaluation* Process and Outcome of the feasibility Study 3 - Has t h e i s s u e s and c o n c e r n s to w a r d t h e im p le m e n t a t io n o f t h e s t u d y / i d e n t i f i e d by th e r e s e a r c h e r ? a .H a s t h e c o n c e r n s and i s s u e s h a n d le d a p p r o p r ia te ly by th e r e s e a r c h e r ? b.W as o r g a n i z a t i o n a l c l i m a t e a ssessed ? h . What w ere t h e s t r e n g t h s o f t h e ap p roaches u sed to con d u ct t h i s stu d y ? 5. 5 ^ 3 2 1 5 ^ 3 2 1 ‘ 5 c . Was p la n n e d c h a n g e s t r a t e r i e s u s e d d u r in g t h e im p le m e n t a t io n o f t h e stu d y ? I f t h e B im ila r t y p e o f s t u d y w ere t o be c o n d u c te d i n t h e S c h o o l o f N u r s in g and A l l i e d H e a lth S c i e n c e s , w h at im p r o v e m e n ts w o u ld you l i k e t o s u g g e s t ? 334 conts ** 3 2 ,_1 5 ^ 3 - 2 1 APPENDIX R: SURVEY: RESPONDENT COMMENTS APPENDIX R Nursing Ed. Survey for Potential Students (RNs) Re spoildent # Question #23__________________________ Question #24 X _____________________ I think the BSN program should be re-eval­ uated for the full-time employed RN. I find it difficult to get counseling/ classes ect. on my current schedule. 2 None I am transferring to UofM Flint for com­ pletion of B.S.N. I am no longer interested in pursueing any health related field at S.V.S.C. 3 To obtain degree & practice as clini­ cal nurse specialist. 4 5 To Keep abreast in the rapid changes in nurses & be prepared to help my­ self & others meet these challenges. 6 Better educated RN. Consequently, bet­ ter able to perform my job. But even­ tually teach or administrate. 7 Call me when your MSN program becomes ac­ credited. 8 9 To broadne my job security & oppor­ tunities & job enjoyment & fulfill­ ment. 10 to further my education & allow me a greater opportunity to advance my career. 11 To be qualified for a better posi­ tion. 12 13 14 15 Preparation far administrative posi­ tion. 16 335 Respondent # Question #23 17 Further cdue. 18 Become a Clinical Specialist in Neurological/Neurosurgical Nusring. Question #24 How long (total) semesters to complete the program? Proposed curriculum? 19 20 21 22 Would like to see more done with the BSN program for RN's. More credltability gived for years worked as a RN. X feel having an MSN program is very impor­ tant Zn this area, but there are alot of RN's still working on their BSN----- 23 Continuing Education for further ad­ vancement as well as personal achievement. 24 Self-fulfillment Would be interested provided adequate credit is given for (1) other graduate degrees (2) work experience (3) opportunities for CLEP exams. 25 My objective would be not only to better my job position, but also for personal goals. If SVSC began a program X would definatly apply, if it fit in with my job schedule. X work in the OR and that as a related field is what X would specialize in I had previously inquired at Wayne State, but I cannot afford to take two days aweek off work plus 1^ yrs off for clinical application. 26 27 to enhance education & position in working 28 X think the Master Program would be a good idea if initeated at S.V.S.C. It would pro­ vide more of an opportunity for those in the Saginaw Valley area to enroll in a Masters Program if they plan to further their educa­ tion. 29, This area would benefit greatly from an M.S.N. program. Currently one must travel quite a distance to be involved in an M.S.N. program. As more & more nurses obtain B.S.N.s the area demand for an M.S.N. program will increase as nurses decide to become clinical specialists, administrators, practioners... Terrific idea hope all goes well in the planning, fund­ ing and execution of the program. 336 Respon­ dent # 30 Question #23 Question #24 To better myself & to allow for advancement in my career. I feel it would be a benefit to the tri-cities There is, no other such program available in this area. This is the direction nursing is heading. 31 32 Clinical Nurse Specialist 33 To get a master's degree 34 35 36 37 , My objectives are really to increase knowledge in my field to perform my current job more effectively. I would not pursue higher or adminis­ trative positions, 1 love staff nursing on a part time basis 3-4 days a week. I also need time to keep up my hospice and cancer vol­ unteer work. 38 39 I would like to further my nursing career in the field of health pro­ motion by good pre hospital and post hospital care of ICU CCU cli­ ents. 40 to obtain MSN in a field that I could obtain a position in the Saginaw Valley Area. 41 42 Specialty Degree 43 44 45 'Specialize. NBg. Administrative Role in 337 Due to family obligations I would only be able to attend part time. I am hoping the the programs will be geared for this type of attendance. Right now I would either involve my self in pre/post cardiac care or switch to Maternal child health promotion. Central currently is the closest masters program available but I would like to see MSU have a MSN instead of health care administration. Respondent ff 46 Question #23 Queatlon #24 My objective Is to obtain a master's to be more versltal In job opportunitles, and for personal growth goals. My concern about your program Is accepting prior credits (transferring credits) The reason I din't enroll in your BSN, Is due to the poor acceptance of my prior credits. 1 also feel insulted to have to clep out of all nursing areas. 1 could see it if I hadn't been in school for a long time. I don't have the time or money for cleps, with my busy schedule and financial commitments. 47 48 49 50 further advancement in field 51 To further my education, increase my nursing knowledge fie to change my role in nursing. How soon would the program by accredited? Please hurry & complete this program - Mid Michigan needs it! 52 53 To obtain my masters to be able to teach in a nursing program. 54 Advancement in Field 55 Timing of classes, how long it would take to complete. 56 degree as clinical nurse specialist 57 to become a clinical nurse special­ ist in either cardiovascular surgery or pediatric & to teach part-time @ the college level I would hope the MSN would have flexible class hours for full time working students. 58 59 60 61 62 •'Close Proximity 63 64 Preparing myself for a leadership role. Unsure as to which direction I want to pursue - ie specialist ed­ ucator or administration 338 GRE Requirements? Respon­ dent # Question #23 Question #24 65 66 My objective would be to further my knowledge and understanding of nursing and possibly to further ay career on the upward ladder. 67 To enhance my education & career development 68 To obtain a MSN in critical care clinical specialist. 69 To Increase my knowledge of nurs­ ing How much money would ea cr cost? Does the Saginaw Bay Midland area have a demand/need for MSN prepared RNs? Any credit awarded for life experiences? 70 brain stimulation 71 1) increased employment opportu­ nities 2) more money 72 Obtain objectives/criteria to pur­ sue Clinical Nurse Specialist Role in critical care setting. Would program be accredited at start, or after several years? Extra Clinical courses/objectives available to specialize In Critical Care. G.R.E. not a requirement? Possibility of double major? Master's thesis or competency based exam? This area definitely needs a master's pro­ gram! Too bad I'm moving! Good Luck!! 73 74 75 76 Prepare myself for administration Role 77 To be able to teach Nsg. 78 79 80 339 Respon­ dent # Question #23 Question #24 81 82 83 Incorporate nursing theories of management & organizational be­ havior into those acquired through the M3A program, thus developing a broader base of understanding to draw from. Also to increase mar­ ketability 84 If I did enroll at some time it would be to make me eligible for a desired position 85 Expand my knowledge and advance­ ment in nursing profession. 86 Achieving a personal goal, job ad­ vancement, increased earning power, job security. Do you anticipate enrollment requirements to be very competitive at the outset. In What areas of nurBing are you likely to offer the MSN? Will the GRE be part of your entrance require­ ments? 87 To further my education so I can teach nursing 88 89 90 91 To become a critical care instructor in a clinical setting. — Would any concideratlon be given to SVSC grad's who finished before NLN accreditation was granted? 92 93 94 95 Obtain a degree that would allow me more flexibility in choosing a career. To further my education in order to take a more involved role in the nursing profession. 96 340 Would courses from other institutions trans­ fer in to the MSN? Is there such a thing as entering with 'advanced standing'? 97 Question #23 Question #24 These are not in order of priority! Number of PhD prepared faculty. Increased earning potential Proposed starting date Increased marketability Increased autonomy Increased knowledge Personal + professional goal. Increased ability to contribute to society 98 Possible administrative or clinical specialist Great idea! 99 100 Meet career objectives self satis­ faction & achievement 101 Enter Nursing Administration 102 103 I enjoy my current position, but would prefer employment outside of the regime set by a hospital - ie shift work. I enjoy Pediatric cli­ ents & their families, & would like to further myself in that area even perhaps in teaching Pediatrics on a collegiate level. 104 105 Advance my career, continue & fur­ ther my education in a more formal & aggressive way. 106 Future objective to become nursing VP in hospital setting. cost per credit hour. number of students per class number of classes per year. projected start date of SVSC MSN program. 107 My objective would be to improve and enhance my professional growth as an RN How soon is the proposed program to be in effect. Program sounds well thought out - very in­ terested in program. Like the close preximity to home. 341 Would there be any exceptions to admission as I am very interested in a MSN program @ SVSC although my GPA is not @ admission criteria. I know I would be successful regardless of my previous GPA & feel GPA is not the only mea­ sure of success - clinical application and personal & peofessional goals are also impor­ tant . Respondent # Question #23 Question #24 108 To further my education & knowledge base 109 To earn a masters of science in nursing In the area of adult med/ surg, in order to function as a nurse educator or nurse researcher. 110 I would like to further my know* ledge In the care & treatment of adults in a critical care setting} their disease processes, emotional status, etc. I would definitely be interested in a local MSN program that offers a variety of speci­ alty areas, not just focusing the program on that of a Nurse administrator. 111 Long Term Goal - to open a pediatric well-child clinic with focus on pre­ ventive health care (ie - immuni­ zations, school physicals, health Tx, referrals from physicians when appropriate. This clinic would be staffed by RNs, with MD backup prn. To carry out my plan will require a HSN degree Good idea! Send me more info please when proposed plans more definite. I am also interested in the cost of this program, & the availability (if any) of scholarships, grants, loans, etc. 112 To advance positionally in the field of Nursing 1 voyld like to know if any classes in other masters programs at SVSC would be transfer­ able to the MSN. 1 wanted to return to school this fall. 113 To achieve a personal goal Is this affiliation (program) with one of the Universities - Wayne?-U of M7- To further my education to enable myself to advance in the nursing profession 114 115 To open up more opportunities for employment for myself 116 117 I do not feel a need to continue on for a higher nursing degree. There isn't much call in this area for a MSN in areas I am inter­ ested in. I would be more likely to try for a degree in a related field that would blend with nursing.so that when I've had enough of the "rat race" I won't have to leave it entirely behind. As yet there are not enough job opportunities or respect in this area to make all the extra work worthwhile to me. 342 Res den Question #23 Question #24 118 119 I want to set up a Diabetic Clinic with teaching, counseling & exercise programs specifically for the Diabetic Client. 120 I would like to become a community nurse educator within 5-8 years. 121 to expand my knowledge base What classes if any would like to begin starts? should ve take if we before the MSN program increase my desirability in the job market 122 123 124 125 To Further my skills through ed­ ucational background. 126 Until more MSN positions earn over $35,000/yr it is not economically wise to spend the extra money attaining the MSN Education. The burnout factor from working as an R.N. & at­ tending school has killed too many good nurses 127 My objective would be to earn my Master degree to further my pro­ fessional and personal growth. 128 Location 129 Expand knowledge therefore work opportunities as well as salary. 130 131 132 133 134 To further my education and secure a good job position. To further my education and better prepare myself for an advanced career in a larger University Center. 343 Respoildent # QueBtlon #23 Question #24 136 To be a Clinical Nurse Specialist in Med/Surg. 137 To further my Knowledge in the field of nursing & leadership 138 Further my education I hope It Is offered over a longer period of time than the BSN program was. As a part-time student, nine months was not long enough to finish my BSN Career advancement 139 To obtain further studies that would be of benifit towards an administra­ tive position 140 To improve my knowledge base in my field and to Increase my chances of being marketable in the future. 141 To better prepare myself for a posi­ tion in nursing administration. I am currently in Ferris State College's BSN program. It's a satellite program that is held at Gratiot Community Hospital in Alma. Our class number is 20 students from a 50 mile radius. Ve've all found that the program is geared towards the working nurse and find it very nice to have the classes held close to our place of residence. I think that a MSN Sat­ ellite program held at Alma would attract num­ erous applicants for those of us who must con­ tinue to work it would be less stressful than having to drive so far away. I am 40 miles south-west of Alma. Driving to Saginaw would be a strain emotionally and physically. How­ ever a satellite program would be-very attract­ ive to me. I am sure that you would attract numerous applicants if you considered a sat­ ellite program. 1. 2. 3. 142 I don’t want to be the minimum entry level of anything. I have a short term goal of getting as much educa­ tion and clinical skills that are required to be an excellent Nurse and Leader. I would like to stay in the critical care area and not get too fan away from clinical nurs­ ing. I have a long term goal of be­ ing an educater hopefully in the clinical setting. 143 Higher education in the field of Critical Care Nursing. 144 145 344 Would schedules and program be individual­ ized? Would there be clinical experience involved' What would the cost Be? Approx? Respon­ dent# Question #23 Question #24 146 Better job prospects - (?) financial Help - 147 To further my education as a nurse manager Question - What are the alternatives if your GPA is not 3.0. My GPA was 2.5 149 Acquire more knowledge and broaden myself as an individual It has been my experience that continuing my education in nursing is a very frustrating en­ deavor. Nursing as a profession needs to be more realistic and flexible in this area. We need quality programs that also give you some credit for competencies you have obtained. I would seriously consider an MSN program if the courses were such that would inspire and teach rather than frustrate and be a repetition of information and skills covered in undergrad work. Is this asking too much of our profes­ sion??? 150 possibly to become nursing adminis­ trator or a nursing Instructor 151 Advanced preparation for Nursing Ad1 ministration from an accredited MSN Program 148 152 153 My goal is to teach matemal-Child Health Nursing. 154 Furture education for future jobs promotions 155 Continue Education & further pro­ fessional development 156 to continue in I would be very excited at the proposed pro­ gram. I am concerned about what the clinical aspect would consist of. I feel after the clinical in AON & BSN programs its plenty. I would be very Interested in further information I strongly suggest allowing nurses with a Bachelor's in another area, other than nursing to also enroll in MSN program. I have started Wayne States program (Masters) By testing out (NLN's) even though I have a B.S. in Psych, and a Diploma in Nursing. Many major grad schools are doing this now & in Norther Michigan It is difficult to find flexible BSN program for working RN's. Also I would hope you gear program to those that must work full time 157 Further education. work role. Further my 345 Respondent # Question #23___________________ 158 Advancement in nag career 159 1 want to comply with the criteria required to be a full time faculty member and teach at a near by col­ lege dept, of nursing. Question #24 I am I am GPA. your sending for my undergraduate transcript. fairly certain that I did not have a 3.0 Vould this definitely disqualify me from proposed M.S.N. program? I graduated from the B.S.N. program in 1966. Since it has been 20 years, would I have to do any additional classes prior to or in prepara­ tion for entering your proposed M.S.N. program? 160 161 162 To prepose for clinical nurse spe­ cialist role in community or Psych* mental health field or administra­ tion same field. I feel it should be designed to meet the needs of the working nurse. Possibly allowing for independent study in chosen field. Thought should be given to the credits required U of M are lowering some of theirs. At Present I'm undecided as to whether I would Pursue an Admin­ istrative role or Clinical Nurse Spec, role My objective would be to gain Knowledge to better pro­ vide Services to Psychiatric Pts. in whichever Role I chose. 163 164 Further Knowledge base and prepared to teach 165 Be better prepared for the changes ocurring in the role of nurses in changing health care scene. 166 167 168 Improve spills Provides Service 169 Increase clinical competence + Knowledge in community health area 170 Expand my knowledge and Improve my chance for promotion 171 To gain more knowledge in the area previously stated, due to the fact that gaining new knowledge is an on-going process in nursing 173 tfould like to see master's prepared degree in specialty fields 346 Respon­ dent # 175 Question #23 Question #24 To complete the program as indepen­ dently as possible with flexibility of scheduling. 176 177 Broaden knowledge base & improve my administrative & leadership duties 178 Much Needed in this Area. support MSN Candidates Would encourage and 179 Broaden base of knowledge, obtain higher degree and higher level of clinical competency. Definitely needed in this areal 180 To obtain a MSN in communityhealth. Some aspect of it, either toteach or do research I am very interested in this program. It would have to be flexible so I could work full time 181 182 Improve knowledge & skill Increase job mobility & salary 183 to progress personally In nursing to be involved in progressing the scope of nursing 184 Increase my skills/abilities in working/teaching my clients in parent/child health. 185 To become qualified to teach at a accerdeter Nursing school I was initially enrolled in MSN program through Wayne State University in Traverse City locatioi but dropped out before 1st semester completed as there were only 3 students in the Community Health section - and our classes were being cancelled due to lack of sufficient numbers. I really feel a program needs to be sensitive to the needs of full-time nurses. 186 187 188 Further growth and development I feel that some type of office or off campus work credit would be very helpful in completing my masters. The travel distance makes all the class at SVSC impossible for me. 189 Opening up Other Management Posi­ tions or increased ed. background in present position. Would rather see programs that included many hours at me date to make travel time to the area worthwhile. 347 Respon­ dent#______ Question # 23 Question #24 190 Update of knowledge & career advancement 191 To gain expertise in a specific field of nursing How long part-time could the course be taken? What would be the approximate cost per hour? What locations might be possibilities for practicum work? What possibilities might there be for employ­ ment areas/agencies following completion of the M.S.N. in any particular and specific field chosen? 192 Access teaching opportunities increase income 193 To update skills in my present field To provide myself with more qualif. & abilities to improve my position in my field. 194 To Further My Education - & Job Opportunities 195 To further my knowledge base, skills and leadership qualities. 196 to further my education in nursing, to provide better care to my patients. 198 To further my education & better myself 199 Become a Clinical Nurse Specialist 200 To become either a Nurse Administra­ tor, Educator, or Clinical Specialist 205 206 Provide more comprehensive, efficient, effective care to groups of the elderly 207 208 Gerontology 348 Will the Community Health program include Home Health care? Respondent # Question #24 Question #23 210 211 212 The specific area of nursing that was offered Increase information Increase wages 213 214 215 I wish the program was already available. I would certainly attend, but I startend working on my masters in the fall of 1985. Increase my knowledge in nursing Quality for advancement in the nursing profession 216 Job promotion 217 218 I am interested in gerontology, possibly administration or spe­ cialist. 219 My objective is to gain more know­ ledge in pediatrics so that I may grow personally and share my know­ ledge with others. 220 Clinical Nurse Specialist in Crit­ ical Care Hhat programs would be offered in a masters program? .i.e., I'm not clear on what master's of science in nursing would achieve, or would you offer med-surg, gerontology, etc. 221 222 223 greater employment opportunities. 224 225 226 Would you be strict about graduating from an NL: accredited BSN program. The program was 10 years ago & in the process of being accredited I do not know if the accreditedation I now has is retroactive. A clinical specialist or teaching position 227 Would you have a time limit on when to finish the program? 349 Respon' dent ft 228 Question #23_____________________________ Question #24 Better myself to expand opportnities Further my education & qualifica­ tions 229 To build knowledge base in a par­ ticular area and develop expertise to function in nursing roles in the future 230 231 Advancement from current position, as well as, clinical expertise 232 Clinical specialty in critical care areas with emphasis on teaching & hands on nsg-care Would like to enroll in a program that com­ bined adult med/surg with nursing administra­ tion 233 234 Become a clinical specieltist in OB/GYN or community parent child education 235 Gerontalogy Nurse Clinicion Expand on knowledge base/skills in Hed-Surg Nursing to utilize in Institution role. 236 To further my education towards a specific area of nursing 237 Further my employment possibilities 238 Widen my knowledge base in the area of expertise. Improve my job oppor­ tunities & Job satisfaction Cost Time to complete the masters program NLN approved Job opportunities in the area of masters degree 239 To increase my level of Nursing expertise in the administrative or educational role. 240 Professional growth 241 To complete the program, and pursue employment as a nursing Instructor. Excited about proposed program. to being in your first class, Looking forwar The proposed program is an excellent idea. I wish to be kept abreast of progress, as I would like to be one of your first applicants and graduate of the program. This part of our State needs an M.S.N. program. 242 350 Respon­ dent # 243 Question #24 Question #23 Broaden and further my education to expand my qualifications and market­ ability in the job market - develop managerial and educational techniques further. 244 245 Expand knowledge & understanding of professional role Maximize potential (selfactualization) Increase opportunity in job market 246 To further my education toi improve my I will not be working toward a MSN for 5 years. capabilities as a manager; possibly At that time, I'd like to concentrate on Nsg teach part time in the future @ BSN administration with electives in business + level in a leadership course as a computers/finance. I would only attend school practicing manager. part time, taking one class per semester and only in the fall & winter semesters. 247 Nursing Education, enhance job opportunities, and personal satisfaction 248 close to home, easy acces offens program and hours suited to me Grade point lower because of the pace we went with working full time (except during N315 & N 412 - I cut back to 4 days a week) 249 250 Upward mobility. 251 OB-Gyn Nurse Practitioner 252 To further my education to work in a clinical specialist capacity. 253 Further education and career opportun­ ities. 254 Increase my job options. 256 Better job potential 257 To make sure that SVSC has clear, concise able obtainable objectives for a working professional 258 Broaden my scope of job opportunities 259 I would like a career day in which specialist or educators in the individual areas could explain more about their speciality and also discuss the job market + availability for their speciality. How much money per credit hour? 351 Respondent # Question #23 Question #24 260 Possible change in type of nursing I have been doing. 261 Increased job security - greater choice 262 If I did it would be to further my education in nursing & help me de­ velop my own expertise in this . field 263 To increase my knowledge and for better job opportunities 264 More job opportunities 265 Teaching opportunity Need a program with more specific structure for full time & part time students. To obtain HSN for clinlcion to obtain better job role. I would be interested in a clinical specialist role probably in Peds or Grit Care. Is this a possibility? or do you offer/or administrator, educator, or specialist roles? I think having a MSN problem would be a great asset to the Saginaw area, since most colleges that offer HSN problems are quite a distance away. 266 267 268 269 Oncology specialization 270 I would like a master’s program that is convient in distance and hours 271 to become a CNS Interested in more information 272 273 Autonomy in nursing aB an end result 274 To obtain MSN to further my nursing career 352 Cost/cr. hour.. Respondent ft Question #24 Question #23 301 302 303 To advance career 304 To further education & working opportunities. 305 306 I would not have chosen an HSN over MBA, had it been available, nor would I have selected any masters related to nursing. Complete a prgm in research 353 APPENDIX S: COMMENTS BY THE RESPONDENTS OF THE NURSING STUDENT SURVEY APPENDIX S COMMENTS BY THE RESPONDENTS OF THE NURSING STUDENT SURVEY Question Comments 4 My GPA is 2.96. 4 My cumulative GPA is 2.99 currently. 4 The undergraduate GPA should only be 2.5 since the BSN program is already on an elevated scale. 4 Graduating in December, 4 The 3.0 GPA would exclude me, would there be any exception made for students graduating from SVSC nursing programs? 4 My only problem would be the grade point of 3.0. 4 So far. 4 Grade point may not be 3.0. 4 I still have I 1/2 years to complete and I would like at least one year experience in nursing. 4 The grade point of 3.0 1 would be able to meet at this time, but possibly not after this semes­ ter. Upon graduation? 4 I plan to work for 3 or so years (after gradu­ ation) and then go onto higher education. 4 GPA should be lower 2.75 or above. 5 The availability of MSN program will influence my decision. I would be more likely to enroll in the program because of its close proximity. 5 I will not live in the area. 5 I don't know at this time. 5 1 am considering entering a masters program in nursing, but only after gain clinical experi­ ence and starting a family. 5 Depends on if I am in the area. 5 1 was told that it is not advisable to obtain your Masters from the same institution as you have received your bachelors. Saginaw Valley is close to home and must be considered. 3-54 1986. Question if Comments 5 The' BSN program still needs work. I don't feel SVSC Is prepared with appropriate staffing and facilities to handle an MSN program In 2-3 yea r s . 5 Plan to continue part-time at U of M possibly will be able to transfer credits. 5 I am unsure of future plans. If 1 do continue my education in 3-5 years I would certainly con­ sider SVSC. 5 No - I would definitely not apply here. I feel your BSN program is good but I don't believe such stress is needed. I'd hate to think what you'd do to us with a MSN program. 5 I may attend U of M, if I can get a job at that hos p i t a l . 5 Depend on program offered. 5 It doesn't make a lot of sense to go to an unaccredited program. 5 I think it would be wonderful here. 5 I have been in college six years and am very tired of school at this point. I think a MSN program in this area Is a good idea. 5 If I'm still in the area I would attend SVSC for the MSN program, but if not I will attend another school. 5 It depend on the specific field of study that is offered. 5 My long range goal is to complete my MSN as soon as possible and be involved in some type of teaching program. 5 Depends on where my career leads me. to have the program Questions/Comments Would tuition for post-graduate study increase. If so how much as cost would be a, factor toward completion. 355 How soon would these staff members be oriented the SVSC school of nursing? to I question the need for an MSN In this area. The area Is not prepared for masters prepared nurses. What will area hospitals do with MSN's in terms of pay difference, job descriptions, etc. At the current time 1 feel that it would be better to concentrate on developing the under­ graduate program. I feel that the nursing instructor staff is stretched to the limit right now in terms of class load and their own educa­ tional pursuits. Is the staff prepared for a graduate program too? 1 think its a wonderful idea and a great oppor­ tunity. I just hope staffing is adequate. I'm pleased that SVSC is considering a MSN pro­ gram, sincerely hope they are able to receive the grant approval needed. I am pleased SVSC is considering a Master's Pro­ gram and I do hope to attend the program in the future if I am living in or around the area. Question coming to SVSC with new program due to its lack of past experience with curriculum. It would be nice to attend SVSC to maintain consis­ tency in training. However, £ will probably not attend due to its newness! I would like to see it established at SVSC with the same high accreditation of the BSN program. I think a MSN program in this area is a good idea. 1 would qauestion if there was adequate staff to teach a MSN program at SVSC. At this point, we don't have enough faculty to teaching the BSN program. I would also question the credibility of a new masters program and its effect on the learning aspect of the post-gradu­ ate student. Lastly, 1 would be concerned if we had the clinical resources to start a MSN. The area hospitals are already over crowded with LPN, ADN, and BSN nursing students. 356 At this point in my life, I do not feel that I am ready to pursue an MSN program. 1 think it's great! It would be great to be able to complete my gr a d ­ uate work at this same school! 1 feel there is a definite need for this type of program In this area. Competent professionals are minimal in a lot of the nursing disciplines and I feel that by persuing my degree I will have no difficulty in finding work in this area. I think this is a very good idea for people who want to continue with schooling. Too early to submit questions. BSN degree first. 357 I must receive APPENDIX T: COMMENTS BT THE RESPONDENTS OF THE POTENTIAL EMPLOYER SURVEY A PPENDIX T COMMENTS BY THE RESPONDENTS OF THE POTENTIAL EMPLOYER SURVEY Comments BSN/MSNs are regional/Division Home Health Agency Administrators/Managers Do not fully agree with educational states equating with performance ability. Education is very important but not the ultimate need in performance. Not required nor preferred by Hospital Admin­ istrator. We have one RN Clinical Nurse Specialist who has almost completed her MSN, MSN is preferred however due to the inavail­ ability of masters prepared and in fact BSN prepared nurses, many diplomas and ADN gradu­ ates are functioning in these capacities. One wage is paid RNs depending on job not on education. Would need a storng public health work, experi­ ence. Would depend on job description and experience (primarily staff experience) of the person being sought. Management is a key need in all areas. Research would have to be cleared through cor­ porate. Preplanning must occur! No n e . Educational materials, copy (Xerox) facili­ ties, access to records, meeting space. Depending on availability of job and salary desired. (Ours are low!) Would consider and interview. Since the company only employs one at cor­ porate office. Question Comments 14 There would be only the DON position of interest to MSN* 14 It would depend on the organizations needs at any given time. 14 Probably not able to afford. 16 As there has been a lack of BSN programs and their availa b i l i t y , 1 would like to see you consider nurses with BS degrees in other fields. I feel you will limit your program otherwise and exclude some very knowledgeable nurses who have much to offer nursing. 16 Clinical background, required. 16 Sorry 1 could not be more helpful. 16 Creat need in the area. Many good nurses in our locality who need advanced education. 359 at the present time APPENDIX U: THE STEPS FOR DERIVING THE TOTAL NDHBER OF THE BSNs AND POTENTIAL BSNa IN SAGINAW'S SURROUNDING EIGHTEEN COUNTY AREA APPENDIX U THB STEPS FOR DERXVIHG THE TOTAL HUMBER OF THE BSNs AHD POTEHTIAL BSHs IH THB EIGHTEEN COUNTY AREA Step 1: The number of agencies classified by the type of health care agencies were obtained from Table 1 in Chapter III. Step 2: The number of agencies sampled from each type of health care agency were obtained from Appendix K 220) and percent of agencies sample were obtained. Step 3: The sum of the number of BSNs and the potential BSNs for each type of health care agency were obtained by calling each agency by phone. Step 4: The estimated number of BSNs and the potential BSNs were derived for each type of health care agency. Step 5: The total population of BSNs and potential BSNs were then calculated from step 4. Table U.l shows the actual figure for each step. 360 TABLE U.I. STEP STEP 1: Number of Agencies Exist in 18 County Area STEP 2: Number of Agencies Sampled (Percent Sampled) STEPS FOR ESTIMATING THE TOTAL POPULATION OF BSNs AND POTENTIAL BSNs. MediumSize Hospital Small Size Hospital 13 24 Community He alth Agency 11 Home Care Agencies 13 Nursing Homes 31 4 8 (61.52) 12 (50.OX) STEP 3 and 4: Number of BSNs and Potential BSNs in Sample Agencies 392 96 47 18 18 56 STEP 5 Number of BSNs and Potential BSNs in All Existing Agen­ cies 728 190 74 39 43 56 7 (63.61) 6 (46.OX) 13 (41.OX) School of Nursing The total number of BSNs and potential BSNs in the 18 county area, N ■ 1,130. 1 (25.OX) APPENDIX T: LETTER OF SUPPORT FROM VICE PRESIDENT FOR ACADEMIC AFFAIRS - SAGINAW TALLET STATE COLLEGE A PPENDIX V gs) Saginaw Valley State College MEMO TO: FROM: D r . C r y s t a l M. L a n g e , D ean S c h o o l o f N u r s in g D r. R o b e r t S .P . Y i a t y v i c e P r e s i d e n t for'X C ' h S c ie n c e s ' a ir s DATE: Hay 1 4 , 1 9 8 6 ' RE: M a ste r o f S c i e n c e I n N u r s in g X t h a s b e e n my p e r s o n a l b e l i e f t h a t S a g in a w V a l l e y S t a t e C o l l e g e p r o v i d e s a q u a l i t y u n d e r g r a d u a te program I n N u r s in g f o r t h e p e o p l e I n t h e E a s t C e n t r a l r e g i o n o f M ic h ig a n . Our B .S .N . p rogram h a s b e e n a c c r e d i t e d , i t se e m s o n l y l o g i c a l t o t h i n k o n e s t e p b e y o n d w h a t we h a v e now a c c o m p lis h e d . SVSC I s c e n t r a l l y l o c a t e d t o t h e i n d u s t r i a l an d b u s i n e s s c o m m u n itie s o f t h i s r e g i o n . We h a v e a n o b l i g a t i o n t o p r o v id e advan ced e d u c a t io n a l o p p o r t u n it ie s f o r p e o p le i n our s e r v i c e a r e a . A g r a d u a t e program i n N u r s in g w o u ld b e a t i m e l y r e s p o n s e t o t h e n e e d f o r an a d v a n c e d d e g r e e w h ic h i s c u r r e n t l y u n a v a i l a b l e t o r e s i d e n t s o f M ic h ig a n , n o r t h o f Wayne C o u n ty . X p l e d g e my f u l i s u p p o r t t o Im p le m e n tin g a M a ster o f S c i e n c e i n N u r s in g Program o n o u r cam p u s. RSPY/cm 362 APPENDIX W: LETTER OF SOPPORT PROM THE PRESIDENT SAGINAW PALLET STATE COLLEGE APPENDIX W Saginaw Vbiley Sfote College 2280 PIERCE HOAO UNIVERSITY CENTER, MICHIGAN 48710 OFFICE O F THE PAESIOENT Jan e 5 , 1986 D r. C r y s t a l H. L a n g e , R .N ., P h .D . D ea n , s c h o o l o f N u r s in g and A l l i e d H e a lt h S c i e n c e s S a g in a w V a l l e y S t a t e C o l l e g e U n i v e r s i t y C e n t e r , M ic h ig a n 4 8 7 1 0 D ear D r . L an ge: The e f f o r t s o f t h e f a c u l t y I n t h e S c h o o l o f N u r s in g t o e s t a b l i s h a M a ste r o f S c i e n c e i n N u r s in g P rogram a t S a g in a w V a l l e y S t a t e C o l l e g e a r e i n k e e p in g w i t h t h e lo n g r a n g e g o a l s and o b j e c t i v e s o f th e C o lle g e . T h is l e t t e r I s t o c o n fir m t h e i n s t i t u t i o n a l com m itm ent t o s u p p o r t t h e d e v e lo p m e n t and c o n t i n u a t i o n o f t h e M a s t e r ’ s i n N u r s in g P rogram . We l o o k fo r w a r d t o a h ig h q u a l i t y program w h ic h w i l l g r e a t l y c o n t r i b u t e t o m e e t in g t h e h e a l t h c a r e n e e d s o f t h e c i t i z e n s o f M ic h ig a n , and w h ic h w o u ld b u i l d upon t h e n o t a b l e s u c c e s s o f o u r u n d e r g r a d u a te p ro g ra m . Our f a c u l t y h a s b e e n w o r k in g v e r y h a rd t o c o m p le t e t e r m i n a l d e g r e e s i n p r e p a r a t i o n f o r g r a d u a te in s tr u c tio n . S in c e r e ly y o u r s. JM R:nes m n p .l t r 363 APPENDIX X: EVALUATION FORM COMPLETED BT THB DEAN APPENDIX X E v a lu a tio n Process and Outcome of the Feasibility Study For M a s te r s D e g r e e P rogram i n ' N u r s in g 5 4 3 2 1 Has t h e s tu d y -m e t t h e o b j e c t i v e o f t h e d e c i s i o n m ak ers ? Strongly agree agree neutral disagree strongly disagree (5)* a . The am ount and q u a l i t y o f in f o r m a t i o n a d e q u a te ? . b . The r e s u l t s o f t h e s t u d y com m u n icated i n w r i t i n g c l e a r l y ? 3 2 -1 3 2 1 2 1 3 c . Was r e p o r t t i m e l y f o r u s e b y t h e d e c i s i o n m aker ? © 3 Were t h e m e t h o d o lo g ie s e f f i c i e n t f o r o b t a i n i n g n e e d e d in f o r m a t io n ? (5) * 3 2 1 a . t h e d e s i g n o f t h e s t u d y a cco m o d a te d f o r in v o lv e m e n t o f a w id e v a r i e t y o f c o n s titu e n t groups ? (5) **3 2 1 b . t h e m eth od u s e d f a c i l i t a t e d t h e c o l l e c t i o n o f a l a r g e am ount o f d a t a w i t h i n t h e l i m i t e d am ount o f t im e ? (5) y.‘ 2^ i. 3 2 1 c. a c o m p le te p r o p o s a l p r e p a r e d p r i o r t o t h e b e g in n in g o f t h e s t u d y ? d. c o st e ffe c tiv e ? e . A p p r o p r ia te s t a t i s t i c a l m eth od ? S a m p lin g ! D a ta A n a l y s i s i f . k e p t t h e d e c i s i o n m aker in fo r m e d o f th e p r o g r e ss ? 5 0 5 © 3 2 1 5 HU 3 5 W) 3 (5) > 3 2 2 1 1 2 1 g . S o u g h t o p i n io n s o f o t h e r s f o r im p rovem en t o f t h e a p p r o a c h ? 0 4 h . Sought a s s is t a n c e o f needed e x p e r t i s e a t a p p r o p r ia t e tim e ? 0 4 3 2 1 3 2 1 Evaluations Process and Outcome of the feasibility Study 3 * -H*B t h e i s s u e s and c o n c e r n s to w a r d t h e im p le m e n t a t io n o f t h e s t u d y / i d e n t i f i e d by th e r e s e a r c h e r ? conts @ ^ 3 2 1 a .H a s t h e c o n c e r n s and i s s u e s h a n d le d a p p r o p r i a t e l y by t h e r e s e a r c h e r ? (T)*3 2 1 b.W as o r g a n i z a t i o n a l c l i m a t e a ssessed ? (7) ** c . Was p la n n e d c h a n g e s t r a t e r i e s u s e d d u r in g t h e im p le m e n t a t io n o f t h e stu d y ? What w e re t h e s t r e n g t h s o f t h e app roaches u sed to con d u ct t h i s stu d y ? 5 . 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