Student Learning Outcomes Assessment: From Concept through Dissertation

1. Student Learning Outcomes Assessment: From Concept through Dissertation Jane Zaccardi Ed.D, MA, RN, GCNS-BC May 5, 2017

2. Dedication: Practical nursing students past, present, and future. May they always be valued for their vital role and contribution to health care!

3. Objectives of this presentation • Explore the development and implementation of a student learning outcomes assessment project: • general question • identification of the key concept and corresponding learning outcome • identification of a survey tool • impact of literature review • relevant findings • use of the information to inform curriculum • describe how this assessment project led to a dissertation

4. Student Practical Nurses in Action

5. How did we begin? • Question from our Advisory Council: • Employers have noticed a decline in professionalism in the workplace. • Is professionalism taught in the Practical Nursing Program? • Where, When and How? • Begin with the right question(s): • How do we measure the development of professional behaviors?

6. Development of an Assessment Project • Which Student Learning Outcome best “fits with” this question? • SLO #2: Collaborate respectfully with others. • This includes the ability to participate as a member of a group; respect and value diversity; and, operate as a socially and civically responsible citizen.

7. Plan • 1. Curriculum mapping project • 2. Survey of practical nursing students at three distinct points in the program • a. Orientation for new students • b. End of the first semester (18 credit hours of practical nursing completed) • c. Immediately prior to graduation (37 credit hours of nursing completed)

8. The Study • The program director and faculty reviewed course outcomes and learning objectives for each nursing course in the practical nursing program to identify the location key concepts pertaining to professional behaviors were taught. • We recorded pertinent course objectives on our program pathway document

9. Curriculum Mapping

10. Findings • Concepts pertaining to professional behaviors were specifically addressed in 13/15 courses (87% of the program). • More importantly, it was a critical component in all five clinical courses and in both courses that contain lab or simulation experiences.

11. Student Survey • The program director designed a simple qualitative survey tool which asked students to: • Define the word "professional“ • Outline how a Licensed Practical Nurse should: • Look • Act • Interact with others.

12. Findings • 21/21 orientees, 24/32 end of first semester students and 17/19 graduates completed the survey. • All three cohorts of students utilized the word professional in every area on their survey responses. • There were specific terms and/or concepts that were universal in the responses of all three cohorts, and there were several themes that were unique to each level.

13. Professionalism defined • The following terms/concepts were included by all three groups: • the manner in which a person speaks, acts, dresses • positive attitude • soft skills of being "nice"

14. Definition cont. • Orientation group stressed willingness to help others, dignity and pride in self. • Students at end of 1st semester added being on time, following rules and directions, ability to think critically, being calm and using sound judgment. • Graduating students added knowing one's role, projecting confidence, responsibility, accountability and being held to a higher standard.

15. How an LPN Looks • All stressed the importance of: • being neat & clean • wearing one's uniform (most added wrinkle-free) • being organized • "looking intelligent" • Orientees focused on a simple but classy look.

16. Look cont. • End of the first semester students stressed: • looking as though one was ready for anything • having a smile on one's face • appearing trust worthy. • Graduating students added: • appear confident and approachable.

17. How an LPN Acts • All students stressed the need to be • kind • courteous • positive • The orientees added the need for • good customer service skills • compassion • sensitivity

18. Acts cont. • End of the first semester students stressed • ethics and morality • the golden rule • PNs should act the same as an RN • Graduating students stated • they were aware that others looked to them for leadership • being proactive is important.

19. How an LPN Interacts • All stressed the need for • kindness • respect • compassion • open-mindedness • Orientation group added • being helpful • prompt • ability to put the needs of others first.

20. Interacts cont. • End of the first semester students felt that • one should get along with everyone • be empathetic • learn to work well within a team. • Graduating students added • advocacy • integrity • respect for rights and privacy

21. The next phase included • Surveying the advisory council to outline their definitions and expectations relative to professionalism • Comparing and contrasting advisory council members responses with student responses and performance

22. Results of Advisory Council Survey • Definitions included: • presentation and appearance • attitude of life-long learning and growth • compliance with policies and regulations • making proper judgments and decisions • being a self-starter in a supportive environment • meeting minimum requirements for job entry • articulate, confident and competent • honest and aware of legalities • having a quiet dignity.

23. Advisory Council cont. • How does an LPN Look: • All agreed that an LPN should be neat, clean and well-groomed • Compliance with dress code • Some added being prepared and equipped for duty • Put together • Pleasant affect

24. Advisory Council cont. • How does an LPN Act: • on time • prepared and organized • Interested, responsive and appropriate to situation • respect self and others, positive, polite • calm in crisis situations • able to think critically • responsive to diversity • an advocate, • knowledgeable and confident

25. Advisory Council cont. • How does an LPN Interact: • respectfully • listens to others • team player • empathetic, caring or compassionate • calm and thoughtful • does not bring personal problems to work • maintains proper personal space • accepts ideas of others

26. An Additional Student Survey • This survey listed behaviors that faculty and prospective employees identified as being unprofessional • Practical Nursing Students were asked to indicate whether or not they perceived the behaviors as being unprofessional in nature

28. Faculty Review of this Data • Validate consistency with respect to expectations regarding student behavior and socialization between the day practical nursing program • Day Program has 3 full-time faculty/2 adjuncts • Evening Program has 1 full-time faculty and 6 adjuncts • Gather more information about the demographics of each of the cohorts of students.

29. Impact of SLOA on Program • Curriculum revision • Deletion of a couple of courses • Development of a new course • Addition of competencies related to professionalism • Faculty reflection and discussion • Role modeling • Performance expectations in clinical practicum, lab and simulation • Consistency • Review and revision of PN Student Handbook • Poster Presentation

30. Professionalism: Student Learning Outcomes Assessment Project •  • Jane Zaccardi, MA, RN, GCNS-BC DATA COLLECTION • Curriculum Map Data Is professionalism taught in the Practical Nursing Program? • Where, When , and How? How do we measure the development of professional behaviors? --Do PN students develop the ability to collaborate respectfully with others including the ability to participate as a member of a group; respect and value diversity; and, operate as a socially and civically responsible citizen? RESEARCH QUESTION(S) • Survey Data • Orientation Group • Impact of C.N.A. course noted in how the incoming students defined and demonstrated professional behaviors • End of first semester • Focused on critical thinking skills, team work and ethics, morality & integrity • Prior to graduation • Aware of their role within healthcare team and of the fact that others will look to them for leadership NEXT STEPS • Strengths Quest Assessments and Workshops have been integrated into the curriculum • Student representatives will continue to attend advisory council meetings and will inform their respective cohorts regarding perceptions of councils members around professionalism • Scenarios will be developed to be used in simulation to promote transfer of professional behaviors from class to workplace PLAN TO RESPOND TO THE QUESTION WHAT WE DID WITH THE DATA RESULTS • Curriculum mapping project • Survey of members of the advisory council • Survey of practical nursing students at three distinct points in the program • a. Orientation for new students • b. End of the first semester (18 credit hours of practical nursing completed) • c. Immediately prior to graduation (37 credit hours of nursing completed) • Concepts pertaining to professionalism are addressed in 13/15 courses; and, are critical components of all five clinical courses; and, courses that contain lab or simulation. • There is progressive growth in understanding professionalism; and, in demonstrating professional behaviors as a student progresses through the program. • The data was: • Reported out to the Advisory Council • Reviewed and discussed at our Student Learning Outcome Assessment Retreat in May

31. Dissertation Development • Literature review • Survey Tool • Research questions • Findings

32. Literature Review • Professionalism: internally held values (attitudinal) that are measured through (observable) behaviors • Variety of nursing studies existed, but none involving student practical nurses • 5 Distinct areas of professionalism: • Reliability, responsibility, accountability • Life-long learning, adaptability • Relationship with others • Integrity and respect • Citizenship and professional engagement Kelley, et al. (2011)

33. Hall’s Professionalism Scale (1968) as adapted by Snizek (1972) • Hall’s Professionalism Scale (1968) is an attitude scale developed to measure the degree of professionalism of individuals in a variety of occupations. • Hall identified five attributes of professionalism: • use of a professional organization as a major referent • belief in public service • belief in self-regulation • sense of calling to the field • feeling of autonomy.

34. Snizek’s Revision (1972) Hall’s scale contained 10 items for each construct for a total of 50 survey items. Snizek revised the scale to include only five items for each attribute for a total of 25 survey items. Internal Consistency Reliability for my study: Cronbach’s Alpha for subscale 2, belief in public service was .444 Cronbach’s Alpha for subscale 5, belief in autonomy, was .330

35. Attributes of Professionalism and Corresponding Survey Items Note. Adapted from “Hall’s Professionalism Scale: An Empirical Reassessment,” by W. E. Snizek, 2014, American Sociological Review, 37(1), p. 111.

36. Research Questions • RQ1. To what extent did students in a practical nursing program use a professional organization as a resource? • RQ2. To what extent did students in a practical nursing program believe practical nurses engage in self-regulation? • RQ3. To what extent did students in a practical nursing program feel a sense of calling to the field? • .

37. Findings • There were no statistically significant differences in the use of a professional organization as a major referent, belief in self-regulation, or in a sense of calling to the field between students entering the practical nursing program and those graduating from the program.

38. Findings cont. • Both groups appeared to value the professional organization: • Student practical nurses are required to research topics in peer-reviewed nursing journals and through websites sponsored or endorsed by professional organizations. • Professors use resources from various nursing organizations to inform curriculum, develop simulation experiences, and conduct debriefing. • This finding may reflect the impact of curriculum and coursework.

39. Findings cont. The highest group mean was associated with the subscale pertaining to a sense of calling to the fieldwhich may suggest that student practical nurses might not have a strong yearning or intrinsic commitment to become a nurse independent of the salary they might expect to earn. • Employment growth, earning potential and the diversity of opportunities are common reasons students select this career pathway. • Students choose nursing because for job security, shift flexibility, a limited workday, and a relatively high salary. • The concept of a career ladder along with efforts to streamline the path to the BSN to address the nursing shortage have also motivated students to select this occupation.

40. Other Research • Intergenerational considerations • Emphasis in Nursing today: • Autonomy • Membership in professional organizations • Emphasis in Nursing in the 1960’s: • Sense of Calling to the field • Service Wynd (2003)

41. Value of examining SLOs • Course or program review • Brain-storming • Gaining a new perspective • Validating perceptions arrived at through anecdotal data • Acquisition of resources • Positive PR for course/program/college • Identification of student and faculty accomplishments • Ongoing quality improvement

42. Questions • Contact Information • Jane Zaccardi Ed.D., MA, RN, GCNS-BC • Highland Community College, Atchison, KS • (913) 367-6204 ext. 133 • jzaccardi@highlandcc.edu

43. References • Hall, R. (1968). Professionalization and bureaucratization. American Sociological Review, 33, 92-104. • Kelley, A., Stanke, L., Rabi, S., Kuba, S., & Janke, K. (2011). Cross-validation of an instrument measuring professional behaviors. American Journal of Pharmaceutical Education,75(9), Article 179. • Snizek, W. E. (1972). Hall’s Professionalism Scale: An empirical reassessment. American Sociological Review, 37(1), 109-114. • Wynd, C. (2003). Current factors contributing to professionalism in nursing. Journal of Professional Nursing, 19(5), 251-261.