Nursing education is at a crossroads. The tradition of nursing education being completed with an associate degree (ADN), diploma, or a baccalaureate (BSN) degree is being supplanted with the idea that education is a lifelong commitment for all nurses, additional expanded competencies are needed to meet demographic and technological changes in health care, and expanded roles requiring advanced decision making and leadership skills are developing in health care systems.
In recent years, the number of nurses achieving an entry-level BSN degree outnumber those achieving other types of degrees or diplomas (Buerhaus, Auerbach, & Staiger, 2016). Although this is true, it remains that the ADN is a viable and realistic portal for gaining education for a health career as workforce shortages loom sporadically and vary in intensity regionally. The community college has a strong focus on field-based careers at the point of care, is less costly than most alternative higher education options, is located in geographically disperse areas to meet local and regional needs, has a faculty dedicated to the teaching mission, and is attractive to first-generation and diverse college entrants who relate to the culture of inclusion found in community colleges.
Community colleges have responded to the expectation that the BSN degree is desirable for the profession. In recent years, some community colleges offer the BSN degree. In other community colleges, articulation agreements afford seamless postgraduation credit transfers into a BSN degree-granting institution. In still other community colleges, new models of academic partnerships are being formed to expedite BSN degree completion.
An additional model bypasses the BSN degree and creates a master's degree entry. One model, concurrent enrollment in both a community college and a university, is the focus of this article. This model may, in some states, afford the student the option to sit for the NCLEX-RN before completing the BSN degree, which follows in a compressed time frame. Courses are coordinated between the community college and university with no redundancy of effort or duplicative costs.
Professional development educators recognize the body of research that supports the benefits of higher education for nurses, and many hospital-based educators have been strong proponents for obtaining the BSN degree by offering tuition reimbursement. A summary of this research is synthesized by the American Association of Colleges of Nursing (2017). As many organizations seek Magnet® recognition, the requirement for a strong BSN skill mix adds real or perceived pressure on ADN or diploma nurses to pursue the BSN for continued employment. Some states now require BSN degree completion within a specified time frame postgraduation from a community college. Notably, the recent statutory change in New York State requires a BSN degree within 10 years of ADN commencement (Nelson & Mararac, 2017).
NEPIN, the National Education Progression in Nursing collaborative, originated from a previous project known as Academic Progression in Nursing (APIN), led through the Center to Champion Nursing in America, funded through the Robert Wood Johnson Foundation (RWJF), and endorsed by the Tri-Council for Nursing and others. As the APIN grant cycle concluded, NEPIN was established to maintain momentum toward sustaining and testing new BSN completion models for nurses wishing to expeditiously pursue the BSN option while providing educational support and overall encouragement for leaders and faculty sharing the advancement mission.
The RWJF continued to support NEPIN, along with partners that included HealthImpact, the Idaho Action Coalition, New York State Nurses Foundation, National Forum of State Nursing Workforce Centers, Organization for Associate Degree Nursing, Organization for Associate Degree Nursing Foundation, University of Kansas, University of Phoenix, Washington Center for Nursing, and Western Governors University. The NEPIN goal is to build alliances to accelerate BSN progression and to find bold and creative solutions to barriers. An audacious goal has been set—to ensure that one million incumbent nurses and 90% of new ADN nurses achieve a BSN or higher degree by 2025 ( https://nepincollaborative.org/).
Dual Admission/Concurrent Enrollment
As noted above and described by Donna Meyer (2018), President and CEO of the Organization for Associate Degree Nursing, the dual admission/concurrent enrollment model shows promise by fostering intercollegiate collaboration; Meyer reflected that past mandates of a single pathway to the BSN degree have failed in the United States, yet partnership options that focus on the BSN outcomes has reached a successful tipping point. When coupled with RN-to-BSN program options and the creation of nearly 90 new BSN programs (AACN, 2017), the BSN workforce is growing.
Mayer, Schenk, and Spinnato (2018) reported that leaders who desire a copartnership between a community college and higher education university is a natural beginning for a dual admission/concurrent enrollment option, and professional development educators can be a voice for stimulating such a partnership. One of the biggest obstacles to success historically has been linked to financial aid and the high cost of tuition expense linked to baccalaureate education. In their model, a consortium agreement is developed to specify common core courses that are essential to the ADN and BSN programs and the funding for these classes. They also identified how advising will be managed and how financial aid will be processed. The financial aid consortium agreement allows the student attending a community college to take classes required for the BSN degree at the community college by increasing the financial aid award to the student. The community college and university work together to develop and implement the consortium agreement.
Communication is key between the collaborating institutions, with essential relationships needed in each setting between financial aid, advising, registration, and records management. Most schools use a designated point person to facilitate communication flow between students, administrators, and department heads in the aforementioned areas. Experts such as those referenced advise that students list both institutions on their Free Application for Federal Student Aid form so that if withdrawal from the BSN program materializes, financial aid to the community college can be expedited.
Realizing that two collaborating schools will have different academic calendars, technology support enhances any triggers tied to deadlines for course registration, grant/scholarship opportunities, course withdrawals, and advising. There are many details in the process. Schools that report success started concurrent enrollment with small cohorts and with a clear vision to simplify technical and regulatory compliance challenges while making them as invisible as possible to students. They also had a rapid response team solve coordination issues as rapidly as possible. What is important to know is that regardless of the details, these programs are working and growing.
In a spirit of true collaboration, where both academic institutions sit at a balanced table, both parties enjoy mutual benefits. Faculty have reason to share curricular ideas and resources and streamline credits. Students who meet the academic requirements of both institutions are ensured admission, most often contiguous to completing the ADN. Increased enrollments in the BSN program can bring added revenue to the university with enhanced analytic projections. Classroom and clinical time is planned more equitably and less competitively, an advantage to the agencies hosting clinical sites. The community benefits from an increased workforce with expanded competencies.
A Role for the Professional Development Educator
The professional development educator is a bridge builder and convener in a community where dual admission/concurrent enrollment is plausible between two academic institutions. As a facilitator, examine model programs such as those found, among others, in the following communities: Kansas University-Community College Partnership Program; Maricopa Community Colleges system and Arizona State University College of Nursing and Health Innovation; Harford Community College and its three partners with Towson University, Frostburg State University, and University of Maryland School of Nursing; and Northwestern Michigan College and Davenport University.
The educator can collect data, including funds associated with tuition reimbursement, to determine whether resources are available to support dual admission. The educator can facilitate an examination of clinical sites and how a shared academic model influences clinical learning. The professional development educator has a strategic leadership role in the health system to promote the outcomes of higher education in nursing. Finally, the visionary educator will consider how leadership development will be enhanced as nurses are prepared with expanding competencies.
- American Association of Colleges of Nursing. (2017). The impact of education on nursing practice. Retrieved from https://www.aacnnursing.org/News-Information/Fact-Sheets/Impact-of-Education
- Buerhaus, P.I., Auerbach, D.I. & Staiger, D.O. (2016). Recent changes in the number of nurses graduating from undergraduate and graduate programs. Nursing Economic$, 34, 46–48.
- Mayer, S., Schenk, L. & Spinnato, A. (2018, October10). Financial aid: The linchpin for academic progression partnerships [Webinar]. Retrieved from https://nursetim.com/webinars/%C2%A0Financial_Aid_The_Linchpin_for_Academic_Progression_Partnerships
- Meyer, D. ( 2018, October 10. ). Transforming nursing education through cross-institutional pathways. Speech presented at COADN/CACN Joint Fall Conference. , San Diego, California. .
- Nelson, L. & Mararac, M. (2017, December30). New York's ‘BSN in 10’ law and the push for 80% of nurses to hold BSN by 2020. Retrieved from https://nurse.org/articles/BSN-initiative-80-2020/