Standard 3 Aspect D

3d. Enacts admission and monitoring processes linked to candidate success as part of a quality assurance system aligned to state requirements and professional standards.

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Recruitment of Candidates
At admission, School Nurse program candidates are employed by school districts on a preliminary credential and the SNSC program is the final step to complete their clear credential required by the State of California. There are currently four School Nurse Services credentialing programs in California and the pool of applicants is defined by the following requirements: hold a RN licensure, completed Bachelor-degree level education and public health coursework, and been approved for a preliminary credential by the CCTC.  To inform potential candidates about the credentialing process and help them find a program that is the “best fit” for their professional goals, program information is posted on the CSU Fresno and California School Nurse Organization (CSNO) website.  In addition, CSUF School Nurse Services Credential Program coordinators attend the California School Nurse Organization conference each year and facilitate a breakout session with other California SNSC coordinators to introduce potential candidates to the different SNSC programs and their requirements. A CSUF brochure, designed to inform participants about the SNSC program, is distributed during the session. Additionally, a powerpoint of the different programs is shown, followed by a question and answer period.   Also at the conference,  a “Meet and Greet” session is scheduled for potential and current candidates and their preceptors.  On occasion, past students and preceptors have stopped by to say hello and express how much they enjoyed and learned from the Fresno State SNSC program.

SNSC Recruitment Table (Appendix A)

• _{(SNSC Brochure)}
• _{SNSC Google PPT used at conference}

Program Admissions/Selection Process
Candidates for the SNSC program learn about the program in a variety of ways: colleagues, conferences, supervisors at the time of employment, brochures, or via an internet search about the various programs in California.  Once they know of the program, they reach out to one of the coordinators via email for consultation. The coordinator informs them of the prerequisites, estimated cost, application window dates, credential information if an extension will be needed during the program,  and more, through an introductory letter.  The candidate is encouraged to send an unofficial copy of their transcripts to the coordinator for review and as a method to assist the individual candidate with specific guidance on their next steps. More often than not, there are multiple email exchanges between the coordinator and the candidate. These exchanges prevent a candidate from applying without the necessary requirements and prevents discouraging them by not accepting them to the program due to missing prerequisites, unaccredited college units, or other factors. 

• (Introductory Letter)
• (Prerequisite Options)
• (SNSC Brochure)

SNSC Candidate Recruitment and Admission Process (Appendix A)

This table shows the steps for application and entry into the SNSC program.

Application and Admission Process
To apply for the School Nurse Services Credential Program, a completed School Nurse Services Credential Program Application for Admission is accepted between October 1 and December 1 of each year.  There is no fee for this application and the applicant does not need to apply to Fresno State University as the program is administered through the Division of Continuing and Global Education.  Completion of an application and the necessary prerequisites are required before being considered for admission. 

Applicants are responsible to submit official transcripts from all baccalaureate and post-baccalaureate universities. The transcripts must reflect a Baccalaureate degree in Nursing from a Commission on Collegiate Nursing Education agency (CCNE) or from The National League for Nursing (NLN) accredited school with a cumulative grade point average of 2.5 in the last 60 units and a 3.0 in nursing. Students are responsible to ensure that all required documents and transcripts are submitted with the School Nurse Services Credential program application.

• (School Nurse Services Credential Website)
• (SNSC Program handbook)

SNSC APPLICATION REQUIREMENTS
Application and Recommendation forms are on the  Fresno State School of Nursing website.

Official Transcripts. Applicants must include official transcripts with their application from all post-secondary schools.  Transcripts must indicate a Baccalaureate Degree in Nursing (BSN) or a related field from NLN or CCNE accredited schools with a cumulative GPA of 3.0; and show completion of prerequisite courses including Research, Community Health Nursing, and Audiology.

A two-year Associate degree Registered Nurse with a Baccalaureate Degree in another field of study may apply as long as the student completes public health nursing coursework from an accredited California university. 

A completed Application consists of the following documents:

1. Signed Application
School Nurse Services Credential Program Application
2. Two recommendation Forms
One from the district administrator, and/or nursing supervisor
3. Essay/Personal Statement
One page essay stating rationale for pursuing a School Nurse Services Credential using APA format
4. Current California RN License
http://www.rn.ca.gov/education
5. Prerequisite Coursework
Community Health coursework or Public Health Nursing (PHN) certificate

• Nursing Research
• Audiology for School Nurses-3 units
• Introduction to Counseling- 3 units
• Special Education/Mainstreaming- 3  units

6. Ca. Audiology Certification
http://www.dhcs.ca.gov/services/hcp/Documents/dhcs101.pdf
7. California Preliminary School Nurse Services Credential
If currently employed as a school nurse, candidates submit a copy of their California Preliminary School Nurse Services Credential.

8. Official Transcripts from an accredited University
Complete transcripts for all Baccalaureate and nursing related courses including pre-required courses.

Candidates who meet the admissions requirements stated above may be admitted to the School Nurse Services Credential program with a Bachelor’s degree from a divergent field of study.  The program believes that by allowing candidates from other health related fields allows for a rich area of discussion and sharing of expertise in the program.  However, all candidates must be licensed registered nurses who have completed the course prerequisites of community health, nursing research, counseling, special education and audiology for school nurses allowing for common language in health areas. 

Selection Process of Candidates/Rubric
Admission to the SNSC program is based on a point system using a rubric. The use of a rubric gives a well-defined and consistent plan to assess candidates and make selections for the program; and aligns with the stated requirements on the CSUF website.  Scoring the rubrics is a time-intensive process but it minimizes subjectivity and bias.   CSUF scores candidates within the Central Valley a point higher since the goal of Fresno State is to reach those within its boundaries.  In person interviews are not held since this program is offered statewide.  The multiple email exchanges between the candidates and the coordinators provides one method of getting to know a candidate before accepting them to the program.  The rubric lays the groundwork for equitable and non-discriminatory acceptance of candidates. 

Demographics
Demographics are not collected as part of the program admission process. The CCTC, however, collects demographics once a candidate applies to the state for their final credential and data demonstrates that candidates reflect varied demographics but are not necessarily representative of California. Program coordinators seek to improve diversity in school nursing by improving the visibility of school nurses, inviting student nurses into schools to demonstrate that  school nursing is an important clinical option and by advocating for better school nurse/student ratios with professional organizations through legislation. California mandates school nurse services but not school nurses. Although the National Association of School Nurses recommends a school nurse in every school, in California, the reality is closer to one school nurse for every 3-4 schools. With the recent (2021) passage of AB 130 the California Governor signed the Education Omnibus bill containing funding for a School Nurse Health Consultant and the creation of an Office of School Based Health, there is hope that school nurse ratios can be changed.

CCTC Demographics Post program Survey. (Not all CCTC applicants filled out this portion and candidates can mark more than one ethnicity)  Ethnicities marked included:  Hmong, Korean and Chinese.

• _{(CCTC report link)}  

GPA at admission
The CSU Fresno School of Nursing requires a 3.0 GPA from the last 60 semester units. The SNSC program follows this requirement as stated in the SNSC Program Handbook. Keeping the GPA at 3.00 allows for candidates from divergent backgrounds and second language candidates to enrich the program.  

No pre-exam scores are used as our candidates are California licensed registered nurses with Bachelor level degrees from accredited universities recognized by the CCTC. In addition, they have been awarded preliminary five (5) year School Nurse Services Credentials issued by the California Commission on Teacher Credentialing. Our program helps candidates complete the preliminary requirements to a Clear School Nurse Services Credential.

Prerequisites
The SNSC program currently requires that candidates have completed a Bachelor of Science in Nursing (BSN) degree, or other health related degree, complete Community health coursework, Nursing Research and the required three prerequisites:  Special Education, Counseling and Audiology.  Candidates who have not completed prerequisites are encouraged to apply again after completion.

Extensions
School Nurses on a preliminary credential must complete all coursework for the final credential clearance within five years or apply to the CCTC for an extension appeal. Candidates who have been accepted into the school nurse credential program may request the program coordinators to assist with a Letter of Recommendation/SNSC program verification to assist in the appeals process.

Commission staff may issue an extension of time by appeal for a credential or permit when an applicant verifies good cause for not completing the renewal requirements. An appeal may be issued only once, except in cases where the extenuating circumstances continue to exist and the applicant has made sufficient progress toward completion of the requirements. Extensions, once granted, are for one year. If another extension is needed the candidate reapplies to the CCTC. 

Monitors Student Progress/Key Benchmarks (See Appendix A)

Candidate Benchmarks
In order to monitor student progress, each student has a file with a check off sheet to track program documents and forms.  A checklist confirms that all candidates meet program admission requirements as well as program completion requirements.  The file is monitored by program coordinators.

• (Admissions checklist)

Decision points in the SNSC Program where Candidate performance is analyzed. (Appendix A)

Candidate Monitoring of Progress
Candidates are assessed at the end of each semester, with the expectation that a GPA of 3.00 is achieved in SNSC coursework. Candidates who fall below this GPA or who are having extreme difficulty in seminar or practicum courses are flagged and consultation with program coordinators is initiated to see if assistance can be given. In addition, consultation with the candidate might determine if this program is a “best fit”.  A mandatory mid-term conference between candidate, preceptor and clinical instructor takes place to discuss progress towards learning goals, and other conferences may be scheduled as needed. For candidates in the Fresno and surrounding areas, field supervision/ conferences may take place at clinical sites. For distance learners, 3-way telephone conferences or Zoom meetings are held. At the end of each practicum, preceptors rate candidates in School Nurse competencies on the Preceptor Checklist of Skills and Competencies Form. Candidates who rate below a 4 are noted for potential follow up.

• (Preceptor Checklist of Student Skills and Competencies Forms N186/N187)
• (Admission Rubric Form)

Final Assessment of Candidates
Prior to recommending each candidate for a School Nurse Services Credential, one or more persons responsible for the program determine through documented evidence that each candidate has demonstrated satisfactory performance on the School Nurse Competencies (SNCs) contained in the Preceptor Checklist (of Skills and Competencies). The program uses formative assessment processes to inform candidates of their status in relation to the SNCs, and to assure that candidates have the appropriate knowledge, skills and abilities prior to being recommended for the credential.  The evaluation of candidate competence is provided by at least one school nurse preceptor and one institutional supervisor. In both NURS 186 and NURS 187 practicums, faculty monitor candidate progress through clinical journaling and provide feedback.  Preceptors are responsible for informing faculty of the candidate’s ability to competently carry out required skills and competencies in clinical practice and to sign off on the Preceptor Checklist (of Skills and Competencies). Preceptors are responsible for assessing the candidate’s ability to incorporate Professional Dispositions into their school nursing practice and evaluate the candidate and sign off on the Professional Dispositions assessment form.

• (Preceptor Checklist of Skills and Competencies)
• (Preceptor Evaluation of Student Performance)

Grades required for Mastery
Grades are carefully reviewed by course instructors and program coordinators. Candidates must demonstrate mastery in coursework by achieving an average GPA of 3.00 and be recommended for a SNS credential by program coordinators.

Candidate Mean GPA in CSUF School Nurse Services Credential Courses 2017-2020

Final Credential Clearance
The program of study is carefully designed to confirm candidates meet the curriculum standards as set by the CCTC and CSU Fresno. All courses in the program have been approved and are included in the CSU Fresno course catalog. Once a candidate has completed all of the required courses the candidate’s program of study is signed off by program coordinators. Candidates are recommended to the Fresno State Credential Analyst who assists candidates with application to the State of California for the final school nurse services clear credential.

• (Kremen Credential Analyst Link)

Licensing Exam
Candidates are licensed RN’s at time of admission, having passed the licensing exam required by the California Board of Registered Nursing. School nurse candidates have already passed the California Board of Registered Nurses licensing exam as an admission requirement and are not required to pass an additional credentialing or licensing  exam in the state of California. There is an agency that offers a Nationally Certified School Nurse certificate for interested candidates.  Once passed, the credentialed school nurse can use NCSN in their signature. This is not a common practice in California. 

Summary of Findings 3d
Evidence shows that the School Nurse Services Credential Program enacts admission and monitoring processes linked to candidate success as part of a quality assurance system aligned to state requirements and professional standards.

Aspect E →