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Standard 3 Aspect C

3c. Engages with stakeholders, including program completers, local educators, schools and districts, in data collection, analysis, planning, improvement, and innovation.


University Stakeholders Collaboration and Communication
The School Nurse Services Credential Program is a working partnership between the School of Nursing (SON), the Division of Continuing and Global Education (CGE) and The Kremen School of Education.  The SNSC Program coordinators work closely with the Fresno State School of Nursing for coursework, faculty, and application requirement areas and CGE provides administrative support such as enrollment, records keeping, and cost. Information about the SNSC program is posted on the Fresno State School of Nursing website.  In addition, SNSC coordinators collaborate with the CSUF Kremen School of Education on credentialing alignment and work with the Kremen Credential Analyst who oversees advising and administrative services for candidates applying for their clear credentials from the State of California,  or applying for extension appeals.

The SNSC Program Coordinators work to provide seamless entry, program operation, and online support between the three departments.  SNSC Coordinators attend monthly SON faculty meetings as well as periodic Graduate program meetings or professional development as needed, attend Kremen accreditation updates and meet periodically with CGE supervisors for program review.  The SNSC Program’s School Health Advisory Panel, consisting of Central Valley school nurse administrators, provides valuable feedback on the program and its outcomes.

Communication with stakeholders and the program across the state, including local educators, schools, districts.
The School Nurse Services Credential Program establishes collaborative arrangements with other institutions and entities that contribute substantially to the quality and effectiveness of the design and implementation of candidate preparation.  These arrangements include collaboration between School Nurse Credential Program providers and local education agencies for purposes of providing appropriate practicum and other fieldwork relating directly to the practice of school nursing.  Participants cooperatively establish and review the terms of the agreements, including well-defined roles, responsibilities and relationships.

Stakeholder Partnerships/Engagement in the SNSC Program
The School Nurse Services Program is embedded in the local community and works with a diverse group of stakeholders.  Stakeholders range from informational to curriculum recommendations and provide a wide range of opportunities for SNSC candidates to participate in practicum experiences.  In addition, stakeholders bring to the SNSC program discussion of hands-on current medical practice, scholarship opportunities, and SNSC program resources.  Many of the stakeholders are graduates of the SNSC program at Fresno State in the past.

Fresno State School of Nursing (SON)  Faculty Council

How often meet

Involvement and role

Data analyzed

Resulting actions

Once a month

SON assists with SNSC Program Coordination, Monthly Faculty meetings

Curriculum recommendations/changes

Approved curriculum changes of Public Health Nurse (PHN), Counseling, and SPED requirements.

CSUF Continuing and Global Education

How often meet

Involvement and role

Data analyzed

Resulting actions

Twice a year

Administers program, budget, registration of candidates

Annual Program report

Hiring and retention data.

Increased faculty

Budget, Approval of curriculum

CSNO Educators Collaborative

How often meet

Involvement and role

Data analyzed

Resulting actions

Annually

Annual meeting of statewide SNSC program providers

CCTC alignment, Visibility, Public Health Nurse (PHN) criteria, Curriculum

Collaboration between credential programs

School Nurse Services Credential Advisory (AKA School Health Advisory Panel)

How often meet

Involvement and role

Data analyzed

Resulting actions

bimonthly

Review of program and practicums

To keep current on issues facing schools and school nurses

Ability to keep program current with support of local school nurse administration

Children’s Hospital Central California Advisory (location of SHAP meetings)

How often meet

Involvement and role

Data analyzed

Resulting actions

bimonthly

Receive updates on current school nurse practice and issues

Receive updates on current school nurse practice and issues

Professional development for candidates/faculty

California School Nurse Organization (CSNO)

How often meet

Involvement and role

Data analyzed

Resulting actions

Biannual

Coordinators present at annual state conference.  All faculty are members of CSNO..
SNSC Program Recruitment

Visibility, Promote and support candidates and keep up on school nurse challenges statewide

SNSC Program links
Resources provided to candidates.
Professional Dev’t options.

School District Administration/Superintendents

How often meet

Involvement and role

Data analyzed

Resulting actions

each semester

Approve candidate preceptors, obtain signed permission for staff to act as preceptor, obtain Affiliation Agreements

Maintain quality selection of preceptors.  Affiliation Agreements are required by the CCTC and the University for liability issues. 

Feedback via Employer/Supervisor evaluation.

School District Preceptors

How often meet

Involvement and role

Data analyzed

Resulting actions

each semester

The preceptor acts as a role model for the candidate and provides guidance, mentoring, and support. Preceptors work to provide the candidate with a well rounded and meaningful clinical experience reflective of a true school nurse practice.

Quality preceptor mentorship

Program Feedback via 
Preceptor evaluation of Course 
Preceptor Evaluation of candidates
improves program application and content

CSUF School Nurse Candidates

How often meet

Involvement and role

Data analyzed

Resulting actions

As needed

Review of program and Course Evaluations

To keep current on issues facing schools and school nurses

Feedback on program content and provision

CSUF School of Nursing Graduate Committee

How often meet

Involvement and role

Data analyzed

Resulting actions

Monthly

Curriculum Review, program updates

Remain up to date on SON changes, challenges; seek approval of program changes when needed

Approved curriculum changes 2020-2021

Fresno Department of Public Health (Emerging Infectious Diseases taskforce)

How often meet

Involvement and role

Data analyzed

Resulting actions

As needed

Meetings on impact of school nurses in community and updates on communicable diseases Remain current on community health needs to share with students and faculty Practicum options via professional development/contact tracing courses

CSUF Credential Analyst

How often meet

Involvement and role

Data analyzed

Resulting actions

Annual or as needed

Reviews application for preliminary credential extension and clears students  applying for a clear credential

To follow CCTC guidelines regarding credentials

Candidate clearance provided seamlessly

School Nurse Services Program Faculty

How often meet

Involvement and role

Data analyzed

Resulting actions

Meetings as necessary each semester

Review program, discuss challenges, recommend changes

To maintain high quality program and consistency with instruction

Approved curriculum changes of Public Health Nurse (PHN), Counseling, and SPED requirements.

The CSUF School Health Advisory Panel
One example of stakeholder involvement is our CSUF School Health Advisory Panel (SHAP), which meets bimonthly to interface with stakeholders and to engage in program improvement and innovation.  The SHAP consists of Health Services Coordinators/Lead Nurses from school districts in the Central Valley of California. Many of the attendees  worked with or attended the CSU Fresno SNSC program in the past. These nurse leaders meet to discuss current issues in school nursing and the application of school nursing in the school setting. During this meeting the SNSC program gives an update on current challenges and concerns and receives feedback on potential program improvement areas.  This provides an opportunity to discuss any concerns with individual students. Additionally, the meetings are held at Valley Children’s Hospital, a premiere hospital in the Central Valley.  Meetings at this location provide the participants with the ability to speak with personnel from various clinics in the hospital to assist in keeping nurse leaders up to date on medical management of health issues affecting children of all ages. The Valley Children’s Hospital provides professional opportunities that we share with our candidates to assist with professional development.  VCH has been actively reaching out to the SHAP to explore ways they can help support school nurses in the Central Valley.  Recent Central Valley SNSC graduates have joined the SHAP for support in their small districts, plus a student is invited each year to share their perspective on the SNSC program.

Preceptor's Input
Collaboration with school districts is an important part of the program, providing school site preceptors with direct contact between the SNSC program faculty and candidates. Practicum evaluations provide opportunity for individual student skill levels to be assessed and, if needed, learning goals modified. If a preceptor has concerns about a candidate the mid year conference is an opportunity for faculty/preceptor/student consultation and feedback.  Preceptors document skills in professional management and dispositions as well as individual school nurse skill sets. They also recommend a candidate for credentialing. Program coordinators monitor any concerns about a student's progress and invite feedback from faculty if remediation is needed.  At the end of the semester preceptors also evaluate the course giving suggestions as to content and method which is used to assess for future curriculum changes.

Preceptor Evaluation of Course 
Likert Scale: 5=Excellent  4=Very Good  3=Good  2=Fair  1=Poor

Mean Score 2018 2019 2020 Combined score
N186 Practicum 1 (Fall) 4.75 
n=46
4.60 
n=49
4.68
n=47
4.67

 

Mean Score 2019 2020 2021 Combined score
N187 Practicum II  (Spring) 4.69 
n=46
4.66 
n=49
COVID
4.70 
n=47
COVID
4.67

Employer/Supervisor Input
The Employer/Supervisor Survey of Program Effectiveness is given at the end of the program to District Health Services Administrators/Superintendents who employ or supervise program candidates.  These aspects look at how the program prepares students in health assessment areas to improve and support a student’s ability to learn. This is usually mailed one year after the candidates have graduated.  As noted in Standard 1, feedback from employers/supervisors is minimal but the overall rating is positive in areas related to candidate support in practicum/fieldwork areas.

EMPLOYER/SUPERVISOR SURVEY OF PROGRAM EFFECTIVENESS N2016
n=9
    N2020
n=13
   
SCHOOL NURSE SERVICES Excell

Good

Fair Excell Good Fair
Likert Scale: 4=Excellent 3=Good 2=Fair 1=Poor            
Program Standard 8: Field Work Experience            
The program provides candidates with a broad range of hands-on school nurse field experiences in a variety of settings. Candidates are provided with a preceptor for mentoring and supervision during the field experiences. Working collaboratively, course instructors and preceptors encourage and enable candidates to function appropriately and effectively in a school nurse role.

50%

50%

0

77%

23%

0%

Program Standard 9: Assessment of Candidate Competence            
The program provides preceptors with a comprehensive syllabus , faculty support and assistance in evaluating candidate competence, as well as comprehensive evaluation tools relevant to current CCTC (California Commission on Teacher Credentialing) program standards to assist in assessing and evaluating candidate competence in a full range of clinical experiences related to school nursing practice.

44%

55%

0%

92%

23%

0%

Your Overall Opinion of the Effectiveness of the Program in Preparing Professional School Nurses            
Are you satisfied that the program has adequately prepared your school nurse(s) to fulfill the role of the professional school nurse in meeting the healthcare needs of students in you school district(s)? Do the program standards above (CCTC standard guidelines) cover all of the critical program elements that are necessary to prepare effective School Nurses?

55%

44%

0%

92%

23%

0%

Candidate Input
Candidates have the ability to affect the program in their course evaluations as well as end of program summaries of goals and objectives achieved.  

Mechanisms to Collect Candidate Feedback and how data are used:

Knowledge-Based Questionnaire

Description of Tool & How it is Used (when it is administered, how it is administered) Description of How Data are Used to Inform Program Practices Tool Currently in Use? (Y/N)

Pre-Knowledge Based Questionnaire and Post-Knowledge Based Questionnaire.  The Pre-Knowledge Base Questionnaire is taken by the candidate to identify unique learning style characteristics, quantifies critical thinking components, and serves as a communication tool to improve the understanding of each candidate’s professional and prior skill levels.  The questionnaires use a five-point Likert scale to provide educators with data about the thinking process, learning style, professionalism, and work values of each candidate.

The Post-Knowledge Based Questionnaire is taken by the candidate at the end of the program to assess if program goals have been met.

Pre-Knowledge Based Questionnaire
The questionnaires use a five-point Likert scale to provide educators with data about the thinking process, learning style, professionalism, and work values of each candidate.

The Post-Knowledge Based Questionnaire is taken by the candidate at the end of the program to assess if program goals have been met, assess what was learned and suggest program improvement.

YES

Candidate/Preceptor/Instructor, 3- Way Conference

Description of Tool & How it is Used (when it is administered, how it is administered) Description of How Data are Used to Inform Program Practices Tool Currently in Use? (Y/N)

A Mid-Term 3-Way Conference is mandatory for all candidates in practicum courses.  During this conference, Student Goals and Learning Objectives are discussed, as well as progress toward meeting clinical skills and competencies and whether the students feel the SNSC program is meeting their expectations. 

Is the candidate fulfilling learning goals and objectives?

What help or experience should the program recommend to assist candidate progress?

YES

Student Evaluation of course,Student  Evaluation of l Preceptor

Description of Tool & How it is Used (when it is administered, how it is administered) Description of How Data are Used to Inform Program Practices Tool Currently in Use? (Y/N)

Evaluation of Faculty and Courses: Candidates are offered two methods to evaluate their experience in each course;
The Course Evaluation focuses on content and format of course.
Teaching effectiveness: Focus is on faculty effectiveness in teaching the course to meet outcomes.

Used to assess course content and format

Changes needed to maintain current topics applicable to SN

Faculty effectiveness in teaching the course to meet outcomes.

YES

End of Program Self evaluation

Description of Tool & How it is Used (when it is administered, how it is administered) Description of How Data are Used to Inform Program Practices Tool Currently in Use? (Y/N)

Research Question Reflection:
Candidate reflects on learning goals and their achievement and recommendations for the SN program.

Challenges and recommendations for the SN program.

YES

End of Program Evaluation

Description of Tool & How it is Used (when it is administered, how it is administered) Description of How Data are Used to Inform Program Practices Tool Currently in Use? (Y/N)
Overall evaluation of program and program impact. Overall evaluation of program and program impact. NO

Student Voices-Candidate Evaluation of Program Experience

FRESNO STATE SNSC CANDIDATE EVALUATION COMMENTS 2016-2020

  • Thank you in advance for a wonderful year of education.  I truly feel that I have gained a tremendous amount of knowledge that will serve to enhance my practice as a school nurse.  It's been worth every minute. With sincere gratitude and respect, MM.
  • I enjoyed the learning opportunities in this program and appreciated the pleasant and informative interactions with you via Blackboard and email throughout each semester. Thank you for a well-planned and organized program. 
  • I want to thank you so much for your instruction and guidance this past year.  It is a very rigorous program, but has been extremely beneficial.  Thank you! Alisa
  • Thank you for your wonderful school nursing credential classes. I am grateful that I took your classes. I have more confidence in school nursing.
  • Thank you for the guidance as the moderator/instructor for the classes and facilitating my growth as a school nurse.
  • I thank you Patricia for your undying patience and guidance.  You and Candy are by far my favorite teachers in my life long career of nursing. Restfully, Sheryl
  • Thank you so much for your guidance through the entirety of the credential process.-Stephen
  • Instructors were easy to get hold of and I learned a lot from fellow classmates.  There was a wide variety of topics and resources.
  • The course gave me more confidence, knowledge, and allowed me to grow professionally to handle future situations.
  • The course was perfect and I loved it!  I learned a lot from the research questions and we got to pick what was new to us.  I saved all of the presentations.
  • I loved learning from other school nurses and it was great having opportunities to share information.  Assignments complimented our roles as school nurses.
  • I learned so much with the Power points and resources.  I loved the class and would highly recommend it.
  • Instructors and fellow students were amazing.  I felt I received an excellent education.
  • As this is  my 7th year as a SN I did not think I had much to learn..I was pleasantly surprised!

Thoughts about Preceptors….

  • My preceptor was so professional, yet warm, patient, flexible and knowledgeable!
  • Preceptor was very educated and experienced school nurse.  She was very supportive as she juggled extra work duties.
  • A wonderful experience, a valuable resource, always available to answer questions using critical thinking skills.
  • Amazing preceptor who was very supportive of my journey this semester and routinely served as a sounding board for my experience and offered solutions to my questions about how to be a better school nurse.  Highly recommended.
  • An excellent preceptor in guiding me to reach and achieve my goals.

Summary of Findings 3c
SNSC works with a variety of stakeholders both to improve the program quality and impact but also to make sure the program stays current in the ever changing medical climate.  The School Health Advisory, consisting of School Nurse administrators and leadership, supports candidates and resources, Preceptors provide hands-on recommendations for candidates, and data from the Employer/Supervisor survey gives the School Nurse Credential program high marks in the practicum experience and states the SNSC program adequately prepared school  nurses to fulfill the role of the professional school nurse in meeting the healthcare needs of the students in their districts.  Finally our candidates have a voice in reviewing the program content and impact.  In evaluations candidates state that the SNSC program has had an important impact on their ability to improve and perfect the professional role of the school nurse in order to better serve the students, school staff  and families under their watch.

Aspect D →