Standard 1 Aspect B

Standard 1. Evidence shows that by the time of the program completion, candidates exhibit knowledge, skills, and abilities of professional educators appropriate to their target credential or degree, including: Learners, learning theory including social, emotional, and academic dimensions, and application of learning theory.

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The CSUF School of Nursing uses the Neuman Systems Model, a nursing theory based on an individual's relationship to stress, the reaction to it, and the reconstitution factors that are dynamic in nature. Candidates in the program learn that school nurses cannot rely on intuition or unsystematic observations in providing care but must use research and evidence to guide clinical decision making.  Thus, evidence-based practice combines the current research-based evidence with clinical expertise and client preferences to make a decision about approaching the care for a specific child or adolescent. Candidates learn to identify and reduce stressors and strengthen lines of defense in coping with internal and external stressors that impact a child’s ability to function effectively, affecting their ability to learn or a family's ability to cope with the pressures of life. 

Data Sources & Analysis:

• DATA Sources to be introduced:
  Preceptor Checklist of Skills and Competencies-Program Management (Form P106/206)
• Employer/Supervisor Survey of Program Effectiveness (Employer/Supervisor Survey)
• N137-Teaching Strategies for the Health Care Client

Data Source 1

Midterm and Final Semester Fieldwork Evaluation, Preceptor Checklist of Skills and Competencies-Program Management (P106/206)
The first measure is the Fall semester (Elementary) and Spring semester (Secondary) Fieldwork Evaluation Preceptor Checklist of Skills and Competencies-Professional Management Skills (P106/206) used by preceptors to evaluate candidates in their fieldwork knowledge at two points.  Candidates are rated on a 5-point Likert scale ranging from 5 “Excellent” to 1 “Poor”.

Perspective: Preceptor

Elements Using:

• Item 1: E33 “Demonstrates the ability of a candidate to model evidence-based health care practice in the delivery of school nursing services in the elementary level as well as uses a theoretical base to guide practice.” (P106) Fall Semester

Example skills from the preceptor checklist:

• • E2 - “candidate correctly carries out the Nursing Process in problem solving and in caring for children in the school setting, including developmental history taking”. 
  • E5 - “Demonstrates ability to develop an age appropriate lesson plan and carry out health teaching in the classroom…”
  • E11 - “expresses insight into the role of the SN as a participant in providing coordinated health services and school health programs to better manage limited resources.”
• Item 2: S33 “Demonstrates the ability of a candidate to model evidence-based health care practice in the delivery of school nursing services in the secondary level as well as uses a theoretical base to guide practice.” (P206) SPRING Semester

Example skills from the preceptor checklist:

• • S7 - “demonstrates an understanding for emergency steps in school wide emergencies.”
  • S12 - “discusses various health issues associated with different types of athletic activities and nutritional requirements.
  • S18 - “discusses issues associated with adolescent absenteeism and the role of the school nurse in preventing school drop-out.  Describes various alternative programs to help teens/young adults complete schooling.”

Definition of Success:
The goal of the SN program is to see positive growth from the first to second semester evaluation.  Overall, our goal is that all candidates achieve a 4 or 5 rating which would place all candidates in the Excellent or Very Good categories. 

• _{(SN Professional Management Means)}
• _{(SN Professional Management %)}

Summary of Findings:
From 2017-2020, the ability to demonstrate model based health care practice using application of learning theory, the SN Professional Management indicator data demonstrated preceptors rated N186 and N187 candidates’ clinical performance as:

• Excellent (85%) 
• Very Good (13%) 
• Good (1%) 
• Zero students received a rating of Fair or Poor

Preceptors rated 98% of the candidates Excellent or Very Good.
Average mean scores of candidate professional management skills from 2017-2020 ranged from 4.75 to 4.91 with an average of 4.82.

Analysis and Interpretation
Professional management data demonstrates that preceptors indicate candidates possess sufficient knowledge and skill in the use of learning theory in the provision of healthcare and wellness.   Mean scores are consistently high from year to year.  However, semester mean scores do not demonstrate knowledge was significantly gained midterm to the final semester in Learning Theory.  This could be that as candidates come into the program with two years of experience in school nursing they already have a high level of knowledge in this area or perhaps the preceptors have a higher expectation in the second semester. Other factors may be a change in the candidates’ preceptor from an  elementary school to a secondary school. The majority of school nurse candidates come to the program  with elementary experience, so a secondary school is a new experience for them thus indicating a lack of knowledge. 

Data Source 2

Employer/Supervisor Survey of Program Effectiveness
The second measure is the Employer/Supervisor Survey of Program Effectiveness given at the end of the program to District Health Services Administrators who hire/supervise program candidates.  This is mailed out one year after the candidates have graduated. Candidates are rated on a 4-point Likert scale.

Perspective: Employer/Supervisor

Definition of Success:
Our goal is 100% of candidates will achieve an Excellent or Very Good score.

Elements Using:

• Program Standard 3:  Relationship between Theory Research and Practice
  “By design the program provides a variety of opportunities for candidates to reflect, analyze, and implement the relationships between learned theory and evidence-based practice in clinical experience.  It is evident that candidates examine nursing, education, other theories and research, and their relationship to student health and wellness; school and community health; and student achievement.”
• Program Standard 4:  Program prepares candidates to integrate health and wellness concepts in the educational setting to allow students to be in school healthy and ready to learn.  “Candidates are knowledgeable about primary (disease prevention and health promotion), secondary (health screening, emergency, and acute care) and tertiary (rehabilitative or palliative care) levels of health care in intervention as they relate to students and their families.” (Neuman Systems Model)

EMPLOYER/SUPERVISOR SURVEY OF PROGRAM EFFECTIVENESS

_{(Employer/Supervisor Survey of Program Effectiveness data)}

Summary of Findings
In 2016, the Employer/Supervisor Survey of Program Effectiveness-Standard 3, demonstrates 90% of the candidates were rated Excellent or Good in meeting goals for application of health-related learning theory as perceived by school administrators/supervisors of school nurses.  One hundred percent of the candidates achieved an Excellent or Good rating in a 2020 survey.

The Employer/Supervisor Survey of Program Effectiveness-Standard 4 demonstrates that in 2016 and 2020 one hundred percent of school administrators/supervisors stated the candidates were prepared for application of health-related learning theory to promote student health and wellness as perceived by school administrators/supervisors of school nurses.

The Employer/Supervisor Survey was not distributed in 2017- 2019.  Very few candidates provided appropriate contact information from their district, restricting the ability to send out the survey.  Additionally, when sent out, very few administrators returned the survey. Steps to improve the process are being sought.

Analysis and Interpretation
In 2016 and 2020 Employers/Supervisors of our candidates were contacted and asked to give feedback on an Employer/Supervisor Survey of the SNSC Program Effectiveness.  The survey is a four-point Likert scale.  Out of 26 potential responses in 2016 we received 9 and of 48 potential responses in 2020 we received 13.  In 2016, school administrators rated candidates 55% excellent and 35% good with 10% fair.  In a 2020 survey, school administrators and supervisors stated school nurse candidates have achieved a increased level of knowledge and skill in the knowledge and application of theory in the provision of health care with 100% of the candidates rated Excellent or Good.  This shows the program significantly improved its responsiveness from 2016 to 2020 in the application of health and wellness concepts/theory into the educational setting to improve the provision of healthcare in the school setting.

Data Source 3

Mean Grades for Key Courses & Assignments

Rationale: N137 Teaching Strategies for the Health Care Client explores the nurse's role as a teacher in the health care setting, and principles of teaching and learning are applied to teaching of individuals and groups. The course offers opportunities for online presentations, interactive class assignments and group work. In addition, Nursing 184, 186 and 187 include areas of Learning Theory with Health Teaching and Small Group opportunities.

Perspective: Faculty

Candidates have demonstrated their knowledge in Learning Theory as evidenced by strong performance and grades in the following courses.  Means in Teaching Strategies ranged from 3.86 to 3.89.

Grades in courses focusing on acquisition of knowledge related to learning theory:

Key Assignment: Barriers to Learning Presentation and Individual Teaching Plan (Key assignment: barriers)
The purpose of this presentation is to provide each student with an opportunity to research and assess barriers to learning they come in contact with and how best to deal with those barriers when teaching clients. The student chooses a specific learning barrier of their choice. Examples include illiteracy, ADHD, children or adults with special medical needs that makes learning difficult, developmental delay issues, etc. The student researches the barrier of choice for information on the barrier to include background, significant statistics as well as strategies used for teaching to facilitate learning. 

Our goal is all students will achieve an 80% or “B” grade on this assignment.

Grades for the Barrier to Learning assignment

Analysis of Standard 1b Findings
After reviewing the data from preceptors, employers and candidate GPA, the results show a knowledge of learning, learning theories, and their application. There is evidence the School Nurse Services Credential program has provided candidates with a strong knowledge base related to learning, learning differences and barriers to learning, allowing them to support student success. 

Aspect C →