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AAQEP Accreditation 2022

Appendix E: Evidence of Data Quality

School Nursing

Key Data Measure: GPA of assignment and course
Description of Measure Earned grades of a course or assignment
Process to Ensure Validity Aligned to course objectives and CCTC guidelines of mandated course content for expected SN outcomes.
Aligned to course and assignment rubrics.
Process to Ensure Reliability Criteria for grade determination aligned to course rubrics used by all course instructors.
Course expectations and rubrics published in the syllabus.
Process to Ensure Trustworthiness Grade measures should align with scores from the preceptor skill checklists and other evaluation tools.
Process to Ensure Fairness All students have access to the grading rubric ahead of time and are based on criteria stated in the syllabus.  Any exceptions that differ from syllabus are offered to all students.  Students can access grades over the semester and can access instructor if questions occur.

Key Data Measure: Preceptor Checklist of Skills (Elementary: Form 105/205 and Secondary: Form 106/206) 
Description of Measure Preceptor checklist of skills and dispositions determined by direct supervision of candidate in the field used by preceptors to evaluate candidates in their field work knowledge at two points.  Candidates are rated on a 5-point Likert scale from 5 “Excellent” to 1 “Poor” on 40 items clustered into three areas: Providing Health and Wellness Services (Primary Intervention), Providing Direct Client Care Services (Secondary and Tertiary Intervention), and Professional Management Skills.
Process to Ensure Validity Criteria scored is clearly defined and stated in multiple areas.  Criteria aligns with CCTC requirements of necessary skills for school nurse outcomes.
Process to Ensure Reliability Preceptors rate candidates and sign off skills during direct supervision of the candidate.  Any discrepancies are discussed and reviewed with instructors of course
Process to Ensure Trustworthiness Coordinators individually judge candidate applications and meet to discuss discrepancies.
Preceptor scoring should align with GPA/Instructor assessments.
Process to Ensure Fairness Preceptor skills check off evaluations are posted in the syllabus and available for student review.
Students receive feedback and review. Instructors review preceptor skill checkoff for relevance and scoring.

Key Data Measure: Employer/Supervisor Survey of Program Effectiveness
Description of Measure The Employer/Supervisor Survey of Program Effectiveness is administered to District Health Services Directors or Administrators who hire/supervise program candidates one year after candidates have graduated. Candidates are rated on a 4-point Likert scale in 10 areas that align with the CCTC School Nursing Program standards.
Process to Ensure Validity Criteria based on SNSC program objectives and goals.
Process to Ensure Reliability  Coordinators review scoring and comments and look for patterns of results to improve the program.
Process to Ensure Trustworthiness Coordinators individually review employee/supervisor evaluations and meet to discuss discrepancies.
Process to Ensure Fairness Feedback from employers/supervisors solicited and discussed at SNSC Advisory meetings to determine needed program changes.

Key Data Measure: Pre-Knowledge-Based Questionnaire & Post-Knowledge-Based Questionnaire
Description of Measure The Knowledge-Based student self-rated questionnaire is administered at the beginning and end of the program as a way to measure candidates’ perceived knowledge at program entrance and after program completion. Items on the survey are clustered into 22 core areas: Coordinated School Health Programs, Standards of School Nursing Practice, Nursing Models/Theories, Families at Risk, Neurological Screening Tests, Legal/Ethical Issues, and Child Abuse. 
Results provide the School Nurse Services Credential (SNSC) Program faculty an idea of the candidates’ knowledge base at entry and areas needing additional assistance to meet the SNSC program competencies. Following the questionnaire, students develop individual goals and objectives based on their learning needs.
Process to Ensure Validity The items included on the questionnaire include key items to be learned in the School Nursing Credential program and are aligned with the CCCTC Program Standards.
Process to Ensure Reliability  Results from the questionnaire, particularly from the completers, are triangulated with student performance on course assignments and preceptor evaluations. Because we find alignment between these different measures, we believe the questionnaire is a reliable instrument.
Process to Ensure Fairness All candidates have the same access to the questionnaire. Their results are not counted against them in any way. Rather, the beginning-of-program results provide a way for candidates and program faculty to focus the learning experiences. At the end of the program, the questionnaire provides an opportunity for candidates to reflect on their growth and for faculty to learn candidates’ perceptions of their learning.

Key Data Measure: CCTC Completer Survey
Description of Measure Beginning in 2018, the CTC has administered a survey that is completed by completers of credential programs other than pre-service teaching. The survey, administered between September 1 and December 31, examines the effectiveness of individual educator preparation programs approved to operate in California. In 2019-2020, 95.6% of  the 225 individuals who completed a School Nursing Credential program in California responded to the survey. Of those who responded, 96.7% completed their credential at a California State University.
Process to Ensure Validity This instrument has been used to evaluate the effectiveness of School Nursing Credential Programs across the State of California. Items are specifically tailored to completers of School Nursing Credential Programs and are clustered into five general areas: Background Information, Admission Process, Program Faculty and Coursework, Field Experience, and Assessment and Feedback/Program Guidance and Support.
Process to Ensure Reliability  The reliability of the instrument comes from two principal sources, the number of responders and the extent that their responses concur with one other. The instrument becomes increasingly reliable to the extent that the items are answered in similar ways by increasing numbers of completers of School Nursing Credential Programs. Each year the data set yields the percent of respondents who gave specified answers to each item and includes reliability estimates in the form of confidence intervals based on the number of respondents and the concurrence or homogeneity of responses.
Process to Ensure Fairness Data were not constructed with bias. The existence of this statewide instrument allows us to examine trends in perceptions of individuals who were prepared as School Nurses across the system and compare them with perceptions of individuals who completed our program. Because the survey is administered statewide, we believe it is a fair and trustworthy instrument.

Key Data Measure: Professional Dispositions
Description of Measure This instrument is used by preceptors to assess the candidate’s ability to competently carry out required skills and competencies in clinical practice.  Items address behavior needed for successful practice, including ability to engage in reflection, critical thinking, ethical judgements, valuing diversity, collaboration, and lifelong learning. Candidates are evaluated in each area on a 5 point Likert scale as observed by the preceptor in clinical practice.
Process to Ensure Validity The dispositions listed on the rubric align with disposition critical for a successful school nurse.
Moving forward, we will continue to review the instrument to ensure that the disposition rubric definitions are current and clearly stated.
Process to Ensure Reliability  Moving forward, we will review the assessment forms with preceptors to ensure that all are in agreement with the rubric and how candidates are to  be scored.
Process to Ensure Fairness Although this is an observational tool, the data is compared to additional assessment tools by which a candidate is scored for a composite picture of a candidate.  Data can be compared between different preceptors for discrepancies to ensure fairness.

Key Data Measure: N186 School Nurse Practicum I-Key Assignment: Special Education Cross Cultural

Across Standards 1 and 2, we utilized grades and candidate performance on key assignments. While we believe these assignments do reflect valid, reliable, and fair practices, moving forward, as a faculty, we will engage in inquiry to ensure this is indeed the case.

Mean Course Grades: The average GPA candidates achieved on a given assignment.

N186: Special Education Cross Cultural Case Study: The purpose of the assignment is to gain a broader perspective and more in-depth understanding of the Student Study Team and Individual Education Plan assessment team function, while exploring various cultural health beliefs and practices and how it affects the students ability to learn.

N136: Health Assessment:  A review of body systems, conducting health assessments, and how impairments can affect learning and function.

N184: Individual Health Care Plans: Purpose of the assignment is the development and implementation of an individualized health care plan by a school nurse of all the medical care needed to allow a student to attend school safely.  Used for the documentation of care/education of staff and monitoring of student’s health status and the safety of the school environment.

N184: Cultural Book Report: Books are assigned to enhance the cultural competence of school nurse candidates and to gain insight into the diversity of cultural practices and health care beliefs of the school community.

N185: Orientation/Staff Training Design Project: Purpose is to develop the school nurse manager role.  Assignment is to research, design and develop an orientation for health services staff taking into account federal, state, school practice, and law that impacts a school community.  As part of the orientation, the school nurse must design a program to implement and monitor training in health areas.

N186/N187: Leadership Role or Experienced Nurse Project: The purpose of these options is to give candidates additional choices for gaining clinical hours while encouraging them to stretch themselves outside their daily roles. 

N186/N187: Personal Learning Goals and Objectives: The candidate is able to personalize their learning experience by focusing on areas they are least comfortable in or have limited experience in order to have a well-rounded experience in the school.
Process to Ensure Validity In order to establish content validity, we will analyze the key assignments to ensure they focus on content that aligns with the intended outcome of the course. Additionally, we will review rubrics to ensure that they in fact measure the key content areas the assignments are intended to assess.
Process to Ensure Reliability  In order to establish reliability, as a program faculty, we will engage in joint scoring of student work using the established rubric to ensure that we are all in agreement on how the assignments should be scored. Where disagreements arise, we will work to come to a common understanding. We will repeat this process on (an annual, biannual, regular) cycle to ensure the ongoing reliability of the measure.
Process to Ensure Fairness To ensure fairness, we will analyze assignment instructions to make sure expectations are clear. One way to engage in this process is to have candidates articulate their understanding of what the assignment asks. Where discrepancies exist between what we intend candidates to do and what they understand, we will revise instructions to ensure they are clear to all. We will also be sure that clear details are provided about how the assignment will be assessed, including specific rubrics and, whenever possible, samples of previous students' successful work.

Appendix E: