ATB 1-2-3 Leading the Way for Academic Progression in Nursing Karen Wons, MS, RN, CNE Associate Professor, Project Director for the ATB Grant NSPII 17-102 League for Innovations Conference: March 18-21, 2018

Overview CCBC Nursing Background - Associate to Bachelor’s Initiative ATB 1-2-3 Model: Creating a Culture of Academic Progression Outcomes to date Challenges/Successes Invitation to the ATB Faculty Resource Website

CCBC Nursing (A.S.) Large multi-campus college serving > 62,000 Credit students 56% minority 58% female RN students - 550-600 Offered on two campuses Day: spr & fall Evening-weekend: fall Online hybrid: spr & fall LPN/Paramedic bridge LPN students – admit 40/yr Offered Dundalk campus Day - summer start EnrollmentTotal student count: 62,362 Credit enrollment: 29,115 Full-time1: 3,165 (5%) Part-time: 25,950 (42%) Non-credit enrollment: 33,247 Annual FTETotal: 16,705 Credit: 74% Non-Credit: 26% Minority StudentsCredit: 56% Non-Credit: 45% Student Characteristics Male: 42%    Female: 58%  Student AgeUnder 20: 10% 20-29: 36% 30-39: 18% 40-49: 11% 50-59: 11% 60 & Over: 15%

of nurses will have BS degrees IOM GOAL by 2020 > 80% of nurses will have BS degrees Background for ATB IOM goal/ Carnegie Foundation /Research Hiring trends for RNs Traditional model – A.S. degree, NCLEX, work, more pre-reqs, low % go on to RN-BSN program, often taking significant time, repetition of coursework ATB model – pre-reqs both degrees, dual enrollment in A.S. and B.S. programs, less time to completion, avoids repetition of coursework

of nurses will have BS degrees ATB Model – How it Works Key features of model: Complete pre-reqs for both A.S. and B.S. programs Begin BSN courses while enrolled in ADN program Take NCLEX-RN upon A.S. degree completion Begin work as RN Articulation agreements – 30 credits awarded Complete B.S. within one year PT - 30-33 credits Goals: Advance IOM’s 80% by 2020 goal Advance diversity of workforce Advance safe, quality healthcare IOM GOAL by 2020 > 80% of nurses will have BS degrees In the original NSPII grant that ended June 2016, CCBC Nursing did the work necessary to create a dual enrollment curriculum model where students have a choice among four university BSN options (online, face to face, hybrid) Key features of the model: Take ADN and BSN pre-reqs at the CC or transfer them in Begin BSN courses in first semester of ADN nursing avoiding redundancy in course requirements where possible (i.e., Health Assessment or Professional Role) Courses taken while in AD program, take advantage of summer and winter sessions to make progress toward BSN NCLEX upon AS degree with most students seeking full-time employment Complete BSN within one year part-time Goal

Sample Dual Enrollment ATB 1.0 Curriculum Term 1: Fa 17 Term 2: Wi 18 Term3: Sp 18 Term 4: Su 18 Term 5: Fa 18 N153 – 6 cr N129 – 1 cr University course – 3-4 cr University course – 3 cr N160 – 6 cr N218 – 3 cr 2 University courses – 5-6 cr N217 – 3 cr N227 – 1 cr N234 – 5 cr Total cr: 10-11 Total cr: 3 Total cr: 9-12 Total cr: 5-6 Term 6: Wi 19 Term 7: Sp 19 Term 8: Su 19 Term 9: Fa 19 Term 10: Sp 20 N222 – 3 cr N236 – 6 cr A.S. Degree NCLEX-RN 2 University courses – 6 cr B.S. Degree (6 mos post AS) OR may extend another term (1 yr post AS) Total cr: 12 Total cr: 6 Total cr: CCBC’s Nursing Program is 4 semesters with 9 credits of nursing each semester Students make progress toward their BSN perhaps taking one (non-clinical) university course each semester – depends on university – AND by taking winter and summer university courses Post ATB 1.0 Curriculum Plans to Faculty Website

ATB’s Launch Fall ‘12 Developed ATB Option with Towson University (TU) 2011-2012 First pilot class of 17 began fall 2012 Classes taken at CCBC and Towson AS degree in May, 2014 Completed summer, fall terms at TU BS degree in Dec, 2014 Sp ‘13 CCBC awarded ATB grant to expand the ATB option with other universities

ATB’s Expansion Four Partner Options by Fall ‘15 Towson University (Pub) - F2F/some online Frostburg State U (Pub) - 100% online Stevenson University (Priv) - hybrid (20% tuition discount) Notre Dame of MD University (Priv) - F2F

Pre-requisite Courses & Advising CCBC Nursing (34 cr) Varies by University ENGL 101 College Composition I 3 cr BIOL 110 Biology 4 cr BIOL 220 A&P I 4 cr BIOL 221 A&P II 4 cr BIOL 230 Microbiology 4 cr MATH 125 Finite Math* * 3 cr PSYC 101 Intro to Psychology 3 cr PSYC 103 Hum Growth & Dev 3 cr CMNS 101 Fund of Communication 3 cr ELECTIVE Humanities/Arts 3 cr Recommend: Ethics Chemistry (CHEM 107/108) Statistics (MATH 153)** Nutrition (BIOL 256) Sociology (SOCL 101) Ethics (PHIL 240) Can complete these courses at CC tuition rates!

Applying to ATB = 2 Applications Admit new cohorts spring and fall using same CCBC deadlines Must take ATI’s TEAS exam for CCBC Admission Must apply/be accepted to CCBC nursing program Must apply to ATB university using university application Must send transcripts to both programs Joint admissions meetings for ATB once CCBC accepts to RN GPA of 3.0 or higher for university/strong academic record

Major Goals for ATB – NSPII 17-102 ( July 2016 – June 2020) Expanded Pathways to the BSN: ATB 1-2-3 Creating a Culture of Academic Progression * = of entering Fundamentals cohort ATB 1.0 50% enter* 1st semester ATB 2.0 20% enter* 2nd year ATB 3.0 10% enter* 4th semester by 2020 > 80% of CCBC’s ADN students connect to BSN program

ATB 2.0 – Second Year Start Introduce to first semester non-ATB Fundamentals students Plan to take any needed pre-requisite courses Apply in semester two to universities/receive acceptance Begin ATB in semester three/2nd yr

Sample Dual Enrollment ATB 2.0 Curriculum (launched Fall ‘16) Term 1: Fa 17 Term 2: Wi 18 Term3: Sp 18 Term 4: Su 18 Term 5: Fa 18 Begin ATB Here N153 – 6 cr N129 – 1 cr N155– 2 cr University Pre-req course if needed N160 – 6 cr N218 – 3 cr Pre-req course if needed; Apply to 2.0 Pre-req courses if needed; N217 – 3 cr N227 – 1 cr N234 – 5 cr University course – 3 cr Total cr: 9 Total cr: 3 Total cr: 9-12 Total cr: 3-6 Term 6: Wi 19 Term 7: Sp 19 Term 8: Su 19 Term 9: Fa 19 Term 10: Sp 20 N222 – 3 cr N236 – 6 cr A.S. Degree NCLEX-RN University courses – 3-6 cr 2-3 University courses – 6-9 cr B.S. Degree (1 yr post AS) Total cr: 12 Total cr: 6-9 Total cr: 6-9 Post ATB 2.0 Curriculum Plans to faculty website

ATB 3.0 – Connect to RN to BSN Program Target 4th semester non-ATB students Advantages of staying in “student mode” Advantages of having academic plan Edge in hiring process Coaches to navigate the application process

Outcomes Post Five Years The ATB Model Enrollment Trends NCLEX Results BSNs Produced

ATB 1.0 Enrollment since Launch

Fall Trending ATB – Non-ATB

Spring Trending ATB – Non-ATB

ATB 2.0 Enrollment since Launch Year/Partner Spring ATB 2.0 Enrollment Fall ATB 2.0 Enrollment 2016 (w 4 Partners) Not offered 14 (most earn A.S. in May 2018) 2017 (w 4 Partners) 15 2018 (w 4 Partners) 6 *Expect higher enrollment in Fall 2018

ATB 3.0 Non-ATB ADNs About to Graduate Reporting Academic Progression Plans Non-ATB ADN Grads (n)/ Surveyed Month/Year Reporting Have Applied to RN – BSN Program Reporting Acceptance to RN – BSN Program Reporting Plan to Apply to RN – BSN < 6 mos 6 mos – 1 yr 1 yr – 2 yrs N= 61 May 2017 16 10 21 11 3 N= 28* Dec 2017 8 6 7 2 *Responses mostly from Essex students; low response rate from Catonsville students.  

NCLEX Pass Rates ATB vs Non-ATB

ATB 1.0 and Earned BSNs

BSNs to Date: 111 N = 83 N = 20 N = 7 N = 1 111 184 or 60.33% Towson Dec 2014 –May 2017 Dec 2017 Frostburg First BSN Grads Notre Dame First BSN Grad Stevenson May 2018 Total ATB BSN Grads by N = 83 N = 20 N = 7 N = 1 111 Total Entering Eligible to Graduate by Dec 17   184 or 60.33% Major milestone in Spring 2018 – BSNs all four universities! Gubrud, P., Spencer, A. & Wagner, L. (2017) OCNE results – 30% Article title: From Start-up to Sustainability: A Decade of Collaboration to Shape the Future of Nursing

ATB: Challenges & Successes Secrets to Successful Partnerships

ATB Challenges Institution Time to develop ATB agreements/ curricula/print materials/marketing & recruitment strategies Financial aid logistics between schools Advising Credit transfer between schools Securing buy-in from all college departments Course scheduling Generating registration/grade reports for universities Tracking outcome data

ATB Challenges Student New grad residency program requirements may slow timeline to BSN completion Financial aid Year-round attendance Different policies/ procedures/calendars for ADN, BSN schools Course scheduling

ATB Successes Institution Four partner universities (150 potential ATB seats) > 50% of CCBC ADN incoming students now ATB Increased enrollment in ATB pre-reqs Achievement of BSNs Advances college completion goals Supports college mission – Opportunities for diverse student population Meeting workforce needs Possible increased/earlier pursuit advanced degrees

CC Enrollment in University Pre-Reqs

ATB Successes Student University choice Increased access to BSN Clear, seamless dual enrollment pathways save time More affordable pathway to BSN Early connection to university University courses accepted for A.S. degree avoids course repetition Advantaged in hiring process Comfortable at their university when beginning first RN position Students invested in BSN completion Earlier career BSN completion and expanded career opportunities Earlier potential entry to advanced degree programs

Secrets to Successful ADN-BSN Partnerships Identify logical partners (your grads are going to…?) Involve key personnel early at ADN, BSN institutions Select ATB champions at ADN, BSN schools to lead spirit cooperation, respect, problem-solving Provide clear academic road maps curriculum plans, admission criteria, advising

Secrets to Successful ADN-BSN Partnerships Embrace an academic progression culture at the community college Increase online/hybrid BSN course options Desire to contribute to IOM goal and advance education opportunities for diverse students the profession of nursing safe, quality healthcare

Assessing Progress Report (The Academies, 2016) found that CC/university partnerships had significantly increased access, affordability and are contributing to increasing the number of baccalaureate-prepared nurses partnerships between universities and community colleges should be supported where established and should be considered a viable means to increase the number of BSN-prepared nurses in all areas of the country National Academies of Sciences, Engineering, and Medicine (2016). Assessing progress on the Institute of Medicine report the Future of Nursing. Washington, DC: National Academies Press. In 2015, RWJF asked the National Academies of Sciences, Engineering, and Medicine (The Academies, formally the IOM) to study the progress toward meeting the original recommendations and identify areas that should be emphasized over the next five years to ensure continued progress. A second report (The Academies, 2016) provides findings and recommendations relevant to OCNE’s current and future state.

You are Cordially Invited! ATB Faculty Resource Website http://blog.ccbcmd.edu/atb/

ATB: One Incredible Opportunity for ADN Students

ATB – A Dream Come True for Academic Progression

Conclusions ATB model is one promising approach to creating a more highly educated, diverse nursing workforce Provides clear, transparent, time/cost efficient roadmaps to the BSN A win-win-win-win-win for Students Nursing education Health care employers Health care consumers Nursing profession

Acknowledgement CCBC Nursing is the grateful recipient of two Nurse Support II Grants from the Maryland Higher Education Commission under the auspices of the State of Maryland Health Services Cost Review Commission which made the ATB Option and the ATB Faculty Resource Website possible.

Karen Wons, MS, RN, CNE kwons@ccbcmd.edu 443-840-2820