Preparing for accreditation by the National League for Nursing is a difficult and time-consuming task. The energy required by administration and faculty in preparation for this event is enormous. Frequently the feelings elicited run the emotional gamut from total exhilaration to utter frustration. The University of Portland School of Nursing had received an eight-year accreditation in 1972. Since that time the School of Nursing has gone through several curriculum revisions and the criteria for accreditation had also changed.
The dean of the School of Nursing had devised a two-year plan to prepare for the review by the National League for Nursing (NLN). Each member of the faculty served on a committee and was responsible for preparing a section of the accreditation report. Deadlines were set and the Criteria for the Appraisal of Baccalaureate and Higher Degree Programs in Nursing (1977) became the bible of every nursing faculty member.
The faculty had been involved in preparing for the accreditation review since May 1978; therefore, we were well prepared to articulate the curriculum, organization and administration, students, faculty, resources, facilities, and services at the University of Portland School of Nursing. Our problem was how to prepare the majority of students to an appropriate degree of readiness for the site visit. Only a minority of students had been involved in the work of the committees and were attuned to the functioning of the school. A further dilemma was the development of a methodology that would stimulate student interest in the accreditation process. This was a difficult task since their priorities were passing ciass, preparing for discussion groups, preparing for clinical experience and other employment.
The faculty of the School of Nursing believe:
Learning is viewed as a continuous process that encompasses the total development of the individual. Learners within this program are accepted as active participants in the process who interpret knowledge within a framework of their own values and beliefs.
Faculty members serve as facilitators of learning and its transference in an environment in which concepts are applied to a variety of problem-solving situations.
Based upon this philosophy we wanted to make preparing for accreditation a time for learning. We also believed that the active participant experience for the learner would be more valuable and that the knowledge gained would last longer.
Since the faculty and students of the senior year had a positive experience with small group participation in the presentation of the 1980 Spring course, we decided to use this strategy again (University of Portland School of Nursing self-study report, Fall 1980. Prepared for Board of Review Council of Baccalaureate and Higher Degree Programs, National League of Nursing). Each group of students would do an in-depth study of a specific portion of the accreditation report. They, in turn, would share their knowledge, problems, and questions with the rest of the class. We also decided to use the skills lab time for two reasons: (1) students needed the content theory they were currently receiving, and (2) the content for this learning experience would be best presented through a format of active participation.
We found little in our library search for articles on methods preparing students for league accreditation. The one article we did find became a required reading as a point of reference for the students in preparation for their critique of the accreditation report. When the students were informed about the assignment, there was a feeling among them that the exercise was an attempt by faculty to prepare faculty for the site visitation which would take place within a month.
We decided that a positive set was needed for this experience. The goal was to deemphasize the preparation of faculty and to emphasize the learning experience available to all participants whether they be faculty or student, in the accreditation process.
The Accreditation Workshop
The Accreditation Workshop involved the use of four interrelated learning activities; reading, role playing, panel discussion, and small group activities.
The students were required to read the article "Preparing for Accreditation" (Hawken & Reed, 1978) and the section of the accreditation report to which they had been assigned a specific role and responsibility. The accreditation report addressed the criteria established by the NLN and was organized in the following format: Section I - Organization and Administration, Section ? - Students, Section ?? - Faculty, Section IV - Curriculum, Section V - Resources, Facilities and Services. All students were encouraged to read Section TV - Curriculum, prior to the actual onsite visit; but for this learning experience, the two reading requirements were deemed most appropriate.
Students were assigned to one of three possible roles: an NLN visitor, a student, or a representative of nursing service. The students were assigned the roles of NLN visitors or students. Registered Nurse and Licensed Practical Nurse students were assigned to the role of nursing services.
A panel was designed to represent each section of the curriculum report. The panel for Organization and Administration was represented by the administrative team for the School of Nursing and an administrator from the executive branch of the University.
The panel for Students consisted of the administrative team, the student class representatives, and students representing themselves. The panel for Faculty was composed of faculty members from the junior and senior years and students representing themselves. The Curriculum panel included the administrative team, members of the curriculum committee, members of the faculty not serving on the curriculum committee, and students representing themselves. The panel for Resources, Facilities and Services consisted of faculty members, students and the Director of the Library.
The students role playing the NLN Visitors were given time prior to the workshop for small group activities to combine their resources, formulate the best questions, and avoid duplication of inquiry. The panel discussions were arranged with specific time allotments based on the length of the section of the report and the perceived degree of importance the content would have to the student. Sufficient time was allowed for the students role playing the part of NLN visitors to interview the various panel members in some depth. The accreditation workshop was presented over a two-day period with Sections I, ?, and III being discussed on the first day and Sections IV and V on the second day.
The workshop began with an introduction and provision of a "set" by a faculty member. The set contained content related to the accreditation process, the advantages of schools participating in accreditation reviews, the possible outcomes of accreditation and students' involvement during the visit. Students were prepared for the possibility of a visitor observing them in any learning activity (i.e., clinical practice, conferences, skills labs, project groups, or seminars). They were encouraged to answer the visitors' questions openly and honestly.
The panel discussion resulted in a lively interface between panel members, the interviewers, and the audience. Students arrived prepared for the workshop and several had written out their questions in advance. Class participation was so active that the faculty moderator had to frequently stop the discussion to move on to the next section of the report. The quality of the students' questions varied in lévele of sophistication, ranging from questions about the relationship of curricular strands to particular concepts to questions about placement of a technical skill earlier in the program. The students were able to identify the strengths of the School of Nursing and the areas where further improvements were needed. Of particular interest to the faculty were the areas of concern or interest that the student identified by asking many direct questions. These areas included: (1) rank, tenure and promotion of faculty; (2) methods employed by the School of Nursing to assist faculty in remaining current with clinical practice; (3) the degree of impact student evaluations of faculty and curriculum have on the system, issues related to faculty merit increase, faculty retention, curriculum design and implementation, (4) the equity of the School of Nursing Library budget with other professional schools at the University; and (5) the provision of privacy regarding student records.
Occasionally, the discussion became side-tracked when individuals raised issues that were more personal agendas or concerns. The faculty moderators sought to provide an open environment but curtailed discussions that were not pertinent to the workshop (i.e., acceptable/unacceptable grade for clinical learning experience). It was suggested that the individual concerns be routed to their student representative! s ) or presented during scheduled student meetings.
Finally, the students as a group expressed a great deal of frustration bordering on hostility with the library system. The confrontation between the students and the Director of the Library was beneficial for both. The Director of the Library shared the School of Nursing library budget, the rationale for placement of some books on permanent reserve, the problems of theft, the fact that the University's library is not a Health Science Center Library, and the availability of computer searches and interlibrary loans. Almost all of the points covered by theUirector of the Library had been presented to the students at various times during their matriculation in the major, but their motivation and receptive hearing was high during the workshop. The students offered suggestions for alternative ways to take books out on reserve and more effective photocopying procedures to reduce student time waiting in lines.
Provision of information and positive response to the students' suggestions on the part of the Director of the Library diffused the students' frustration and fostered an open communication system between the students and the librarian for the channeling of future concerns.
In retrospect the workshop was a greater success than we had anticipated. The students had an opportunity to read in depth one section of the report and to hear the other four sections presented by their peers. They had an opportunity to ask questions, vent feelings, air hostility, and clarify rumors.
The students were asked to evaluate the accreditation workshop using an openended questionnaire. We received a 90% response from the students. The response was both positive and negative. The negative comments included: four hours was too long, some questions were not related to the accreditation report and, in some cases, it turned into a gripe session. The positive statements made were: good interaction between the faculty and students, information about the accreditation process was helpful in preparing for visit, interest and level of involvement was increased, and that the students had a chance to become better acquainted with the internal mechanics required in operating a School of Nursing. They were also able to analyze the curriculum more objectively and have a better understanding of the University of Portland's Model of Nursing.
Suggestions from the students' further refinement of the process included: to arrange a total faculty student forum focused on curriculum decisions, to have regular meetings to ventilate frustrations and anger, and to use brainstorming sessions with faculty and students to prevent the airing of student complaints during class time.
Following the visit, students' interest in knowing the outcome of the accreditation process was high. They were interested in both the strengths and areas for improvement of the program.
In December 1980, the University of Portland School of Nursing received an eight-year accreditation from the National League for Nursing.
- Criteria for appraisal of baccalaureate and higher degree programs in nursing. (Ed. 4). National League for Nursing, 1977.
- Hawken, P, & Reed, S.B. (1978). Preparing for accreditation. Nursing Outlook, 6(12), 761-765.