Journal of Nursing Education

Major Article 

Dual Degree Partnership in Nursing: An Innovative Undergraduate Educational Model

Susan B. Bastable, EdD, RN; Marianne Markowitz, MS, RN

Abstract

We report the success of a unique articulation Dual Degree Partnership in Nursing (DDPN) model. The process used to establish and implement this approach is described. Unlike typical 2+2 agreements between associate degree (AD) and bachelor degree (BS) nursing education programs, the DDPN is designed with a 1+2+1 sequence. Intended to attract high school students, this model provides the opportunity to earn two degrees (AD and BS) while experiencing a 4-year campus living and learning environment. This configuration was accomplished without compromising the integrity of either of the established programs. After collecting data over the past 6 years, this model demonstrates popularity with the traditional-aged student, as well as success from an academic perspective. Statistics on retention, graduation, and NCLEX® pass rates indicate the feasibility and success of the model. Based on the findings, the potential for replication is promising for other colleges interested in a similar collaboration.

Dr. Bastable is Chair and Professor, Department of Nursing, Le Moyne College; and Ms. Markowitz is Dean, St. Joseph’s College of Nursing, Syracuse, New York.

This project was funded by a grant from the Foundation of the National Student Nurses’ Association, in conjunction with the Promise of Nursing Grant Program supported by Johnson & Johnson and other philanthropic individuals and organizations.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Susan B. Bastable, EdD, RN, Chair and Professor, Department of Nursing, Le Moyne College, 1419 Salt Springs Road, Syracuse, NY 13214; e-mail: bastabsb@lemoyne.edu.

Received: January 03, 2012
Accepted: May 09, 2012
Posted Online: August 20, 2012

Abstract

We report the success of a unique articulation Dual Degree Partnership in Nursing (DDPN) model. The process used to establish and implement this approach is described. Unlike typical 2+2 agreements between associate degree (AD) and bachelor degree (BS) nursing education programs, the DDPN is designed with a 1+2+1 sequence. Intended to attract high school students, this model provides the opportunity to earn two degrees (AD and BS) while experiencing a 4-year campus living and learning environment. This configuration was accomplished without compromising the integrity of either of the established programs. After collecting data over the past 6 years, this model demonstrates popularity with the traditional-aged student, as well as success from an academic perspective. Statistics on retention, graduation, and NCLEX® pass rates indicate the feasibility and success of the model. Based on the findings, the potential for replication is promising for other colleges interested in a similar collaboration.

Dr. Bastable is Chair and Professor, Department of Nursing, Le Moyne College; and Ms. Markowitz is Dean, St. Joseph’s College of Nursing, Syracuse, New York.

This project was funded by a grant from the Foundation of the National Student Nurses’ Association, in conjunction with the Promise of Nursing Grant Program supported by Johnson & Johnson and other philanthropic individuals and organizations.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Susan B. Bastable, EdD, RN, Chair and Professor, Department of Nursing, Le Moyne College, 1419 Salt Springs Road, Syracuse, NY 13214; e-mail: bastabsb@lemoyne.edu.

Received: January 03, 2012
Accepted: May 09, 2012
Posted Online: August 20, 2012

The movement to require nurses to have a minimum of a baccalaureate degree (BS) has created a decades-long and arduous debate in the profession of nursing. Recently, this debate has again come to the forefront, much like it did in 1965 (American Nurses Association, 1965). With this in mind, many nursing programs across the nation have pursued statewide articulation models that reduce barriers for associate degree (AD) and diploma-prepared nurses to further their education. For example, in 2009, the New York State deans and directors from both the Associate Degree (AD) Council and Baccalaureate Degree Council at the statewide level approved a seamless RN-to-BS articulation model, which supported the well-recognized “BS in Ten” proposed legislation in the state (Zimmerman, Miner, & Zittel, 2010). Another example is the Oregon Consortium for Nursing Education (Gubrud-Howe & Schoessler, 2008), a prominent collaborative model between 2-year and 4-year public campuses in Oregon. This example provides a standardized curriculum to increase the number of baccalaureate graduates as a long-term solution to the nursing shortage (Tanner, Gubrud-Howe, & Schoessler, 2008). Many other states have either adopted or are in the process of adopting similar education models.

At the national level, professional nursing organizations, as well as private foundations involved in health care workforce issues, have supported the BS as the appropriate level of educational preparation for nurses. Evidence indicates that nurses prepared at the BS level deliver quality and safety in practice across health care settings. The publication by Benner, Sutphen, Leonard, and Day, Educating Nurses: A Call for Radical Transformation (2010), which was supported by the Carnegie Foundation and the Tri-Council for Nursing, called for a more highly educated nursing workforce (Tri-Council for Nursing, 2010). The most recent support has come from the landmark report of the Institute of Medicine, The Future of Nursing: Leading Change, Advancing Health (Institute of Medicine, 2011). This report specifically recommends increasing the number of RNs with BS degrees in the United States from 50% to 80% by 2020. One impetus for all of these state and national initiatives has been the need to elevate the education of nurses to improve patient outcomes (Aiken, Clarke, Sloane, Lake, & Cheney, 2008). Other countries, such as Canada, the Philippines, and New Zealand, already require a BS degree to practice as an RN (Zimmerman, et al., 2010).

The purpose of this article is to share the success of a unique articulation model—the Dual Degree Partnership in Nursing (DDPN). As the first model of its kind in the country, the DDPN was established in 2005 between the Department of Nursing at Le Moyne College and St. Joseph’s College of Nursing at St. Joseph’s Hospital Health Center, both located in Syracuse, New York.

This collaborative relationship, unlike the typical 2+2 (i.e., the first 2 years in an AD prelicensure nursing program followed by 2 years in an upper-division BS nursing program) agreements between AD and BS in nursing programs, is designed with a 1+2+1 sequence (i.e., first year of liberal arts and science courses, 2 years of prelicensure AD nursing curriculum, and the last year of upper-division coursework to complete the BS degree). The student satisfies the curriculum requirements (Le Moyne College, n.d.) of both the AD program and upper-division BS program at St. Joseph’s College of Nursing and Le Moyne College, respectively. This innovative configuration of combining the two programs was accomplished without compromising the integrity of either of the established programs of study. The initial goals were to attract a younger cohort into nursing, increase the retention rates of the traditional-aged student, and to create an avenue for RN-to-BS mobility in nursing. Some key factors contributing to the success of this agreement include a long-standing mutual respect between the institutions, the excellent reputation of both colleges, the close proximity of the two campuses (approximately 3 miles apart), the willingness to work together, and the congruence of institutional missions with similar values and shared goals.

Both colleges are private, religious institutions sharing a history of collaboration dating back to the 1950s. Then, as now, Le Moyne College faculty provided the liberal arts and science courses integral to the curriculum at both the AD nursing program at St. Joseph’s College of Nursing and the upper-division BS degree nursing program at Le Moyne College.

To upstart the DDPN, a $25,000 grant was secured from the Foundation of the National Student Nurses’ Association. This grant was in conjunction with the Promise of Nursing Grant Program supported by Johnson & Johnson and other philanthropic individuals and organizations. This funding provided financial support to cover the initial administrative costs of implementing the curriculum, recruiting prospective applicants, and developing marketing materials. The programs at both institutions are registered by the New York State Education Department; therefore, it was not necessary to seek approval from this entity or any other regulatory agency because the two programs remained intact as originally registered. The model was designed to attract high school students eager to pursue a BS in nursing and provide them with the opportunity to earn two nursing degrees (AD and BS) while experiencing a 4-year campus living and learning environment at Le Moyne College.

Joint Admissions

When the DDPN was initially conceived in 2004, one of the first decisions stated in our mutual contract was that students must be accepted to both colleges prior to their matriculation into the curriculum. The rationale for this decision was based on the ethical principle of justice. It would be unfair to accept students into a program and then decide which students would be allowed to progress to Year II after completion of the first year of study. Instead, progression would be dependent on the academic success of the student (a minimum cumulative grade point average of 2.5) in the Year I course work. Also, by accepting a certain number of students before they entered the DDPN, St. Joseph’s College of Nursing could plan 1 year in advance for the approximate size of the cohort that would be progressing to Year II.

Shortly after the pilot group of students entered the DDPN in 2005, a Joint Admissions Committee was established to review applications for the incoming class entering in fall 2006. This committee consisted of representatives responsible for student admissions at both institutions. For the first 2 years, prospective students were required to complete separate applications to both colleges. However, because the admission criteria of each school were similar, it became apparent that the process for admitting students could be simplified for the applicants, as well as for the reviewers, if a joint application was created. This policy change was also made based on feedback received from applicants and their parents asking for a more streamlined application process. Therefore, beginning with the fall 2007 cohort, those students interested in being considered for admission to the DDPN completed only the Le Moyne application. When nursing was checked as the student’s major of intent, the application was duplicated and shared between the two institutions. Applications are reviewed separately by the internal admissions committees of each institution. Decisions are independently made regarding which applicants qualify for acceptance; the Joint Committee then convenes to determine which applicants are to be chosen for the next incoming class. Prior to this initial meeting, St. Joseph’s College of Nursing determines the total number of students its AD program can accommodate for the fall semester of the following year (Year II of the DDPN curriculum). This decision is made based on the number of faculty, classroom seats, laboratory spaces, and clinical placements available. Another admission consideration is the intent of St. Joseph’s College of Nursing administrators to maintain an approximate 50/50 balance between the total number of AD students and DDPN students admitted and enrolled in its 2-year program.

The Joint Admissions Committee meets for the first time in December of each academic year to review applications submitted for early decision. Thereafter, the Committee meets regularly over the following 3 months to review all of the applications completed before the Le Moyne College deadline of February 1st. Meeting times vary depending on the number of applications received and consists of two representatives from Le Moyne College and three admissions personnel from St. Joseph’s College of Nursing. Due to similar admission standards, rarely is there a dilemma about which students to accept or deny to the DDPN. If a differing opinion exists, the following factors contribute to the committee’s ability to openly discuss and reach consensus: mutual respect for one another, similar lived experiences as nurse educators, and understanding of the qualifications each student must meet to successfully manage the demands of a rigorous nursing curriculum.

The number of applications received from graduating high school students has risen incrementally since the program’s inception. Applications have increased from 21 applicants in the 2005 pilot year, to 171 in the first true cohort in 2006, to 470 applicants for the entering class of 2011 (Table 1). This progressive growth in the size of the applicant pool indicates the popularity of the DDPN, as well as the growing interest by young people in pursuing nursing as a field of study and as a professional career goal. The additional number of students who expressed interest in nursing education as an internal change of major at Le Moyne College or as external transfers from other colleges or universities was not anticipated. Initially, applications from non-nursing majors within Le Moyne College, as well as transfer students from other institutions who met the criteria for acceptance, were considered. These students would replace those in the original cohort who were lost through normal attrition during the first year of study. However, given the limited number of spaces in each class and the increasing number of applications received from graduating high school seniors, it was decided to restrict eligibility.

Dual Degree Partnership in Nursing Admission Data for the First 6 Years of the Program

Table 1: Dual Degree Partnership in Nursing Admission Data for the First 6 Years of the Program

In the past 3 years, only the traditional population of incoming freshman and students enrolled at Le Moyne College who were interested in changing their major to nursing were considered for admission. Students requesting an internal change of majors must apply to St. Joseph’s College of Nursing during in the fall semester of their freshman year using a supplemental (shortened) application form, which was created specifically for these students, who were already accepted at Le Moyne College. If students express the desire to change majors later in the first year of study or thereafter, they almost always need to add another year to their education (known as the 5-year option). The only external transfers currently considered for admission are military veterans under the Yellow Ribbon GI Program (U.S. Department of Veterans Affairs, 2009).

Thus, the DDPN has become a very competitive program, and admission is highly selective. After acceptance into the DDPN, students and their parents are invited to attend an information session in April prior to entering the freshman year at Le Moyne College to learn more about this educational partnership. The information session is hosted by current Year I DDPN students, who open their rooms in the residence halls at Le Moyne College for an overnight stay; the following day, the prospective students then attend one of the current students’ Anatomy and Physiology classes. In addition, a lunch is held at St. Joseph’s College of Nursing for the accepted students so they have the opportunity to see the facilities and meet the faculty and staff.

Our current students are our best recruiters and, as a result, our average yield rate (the percentage of applicants who have chosen the DDPN option) over 6 years is approximately 37%. This average is above the Le Moyne College average across all disciplines. For those students who select the DDPN, they must attend a summer orientation session (as do all incoming freshman at Le Moyne College), during which they are registered for their first-semester courses by the nursing faculty.

Curriculum Model

The idea to create this articulation model arose in response to a local demand for nursing education options in the immediate Syracuse area. Five AD programs are located in the region of Central New York, but no prelicensure BS program exists within a 50-mile radius. When Le Moyne College established an upper-division RN-to-BS program in fall 2004, the College received numerous inquiries from high school students who desired to pursue nursing as a major but wanted a 4-year college experience.

Because Le Moyne College was already providing all of the liberal arts and science courses for St. Joseph’s single-purpose, hospital-based, 2-year AD nursing program, it seemed that the wisest and quickest solution to meet the demand was to strengthen the longstanding partnership that existed between the two institutions. Establishing a generic 4-year program that would compete directly with the existing AD nursing programs in the area seemed to be an overly expensive and time-consuming option. Hence, by joining together, the DDPN was conceived as a viable approach to capitalizing on the strengths of both programs. Also, it offered students the opportunity to earn two degrees in 4 years at a price that was less than the cost of a typical 4-year collegiate education.

The DDPN curriculum consists of 4 years of full-time study (Le Moyne College, n.d.). The curriculum is designed in the unique 1+2+1 model, whereby the course requirements, the sequencing of the nursing courses, and the total number of credits for each program remained the same as before the articulation occurred. The model is constructed for the student to attend full-time study for 2 years at Le Moyne College (Years I and IV) and full-time study for 2 years at St. Joseph’s College of Nursing (Years II and III). However, while students are in the middle 2 years of the program, they continue to take one core general education course at Le Moyne College each semester. This allows students to maintain their matriculated status and complete almost all of their general education (core) requirements, and it qualifies them to live on the Le Moyne College campus for all 4 years. In reality, they are dually enrolled and matriculated at two schools concurrently during the middle 2 years of the DDPN.

In Year I, the student fulfills five courses: Anatomy and Physiology I and II, Critical Writing, Introduction to Psychology, and Introduction to Sociology. These are required courses in the St. Joseph’s curriculum and are standard courses typical of most AD nursing programs. The remainder of the students’ credit load in the fall and spring semesters of the first year consists of core courses, with the exception of an introductory statistics course, which is a BS requirement. To be academically qualified to progress to St. Joseph’s College of Nursing for Year II of the curriculum, the student must successfully complete all courses in Year I, earn a grade of “C” or better in the five prerequisite courses mentioned above, and achieve a minimum cumulative grade point average of 2.5.

In Years II and III, the students commute 4 days per week to St. Joseph’s College of Nursing to take the same nursing courses as the 2-year AD students. One of the strengths of the St. Joseph’s College of Nursing program is that students begin hospital clinical experiences after 6 weeks of entry into this basic nursing program. To facilitate scheduling, the St. Joseph’s College of Nursing registrar works closely with the Le Moyne College registrar to ensure DDPN students have the same days and times for their clinical rotations so that they can be on similar schedules. However, it is important to note that when developing the clinical groups, DDPN students are integrated with the AD students. Regarding travel, although Le Moyne College offered to provide the students with a van for transportation to and from St. Joseph’s College of Nursing, students have preferred to use their own cars and usually car pool to get back and forth independently.

On completion of Year III, the DDPN students graduate from St. Joseph’s College of Nursing in May and are eligible to take the NCLEX® for their RN license that summer. With few exceptions, most students pass this examination on the first try (Table 2). Also, because these students have continued to take one core course at Le Moyne College each semester while enrolled in the AD program, most of them have completed all general education requirements necessary for the BS degree, with the possible exception of two Senior Seminars included in Year IV of their program of study.

NCLEX® Success of Dual Degree Partnership in Nursing After Graduationa

Table 2: NCLEX® Success of Dual Degree Partnership in Nursing After Graduation

In Year IV, the students return full time to Le Moyne College for the final two semesters of study to complete the BS degree requirements. They take 10 BS-level nursing courses; five in the fall semester, which includes a clinical course in Management and Leadership (NSG 410), and five in the spring semester, which includes another clinical course in Community Health (NSG 440). Of note, the curriculum plan for Year IV reflects a course load of 18 and 19 credits in the fall and spring semesters, respectively. However, few students enter Year IV having to take such a heavy number of credits because many students transfer in one or more Advanced Placement or college-level courses taken during high school when they enter Year I at Le Moyne College. Or, the students choose the option of enrolling in a core course at Le Moyne College (or an equivalent course at another institution for which they are granted transfer credit) during the summer after Year I and/or Year II. In addition, students are allowed to take the Senior Seminars during each semester of Year III to fulfill their core requirements, or they can enroll in one or two select BS-level courses in the nursing major, such as Professional Issues and Trends (NSG 330), Health Assessment (NSG 315), or a 300-level selected elective, while completing AD requirements. However, students are highly discouraged from taking any courses in the summer after Year III because they are scheduled to prepare for and take the NCLEX. Thus, with the support of their faculty advisors, students create one or more extra spaces during the first 3 years to move at least one course out of each semester of Year IV. The original curriculum design to show a reduction in credits in Year IV was not changed because every student is advised individually regarding how to lighten the course load prior to entering their senior year.

Retention and Progression

Students find the DDPN curriculum very demanding, as do students in any AD or generic BS program in nursing. Particular efforts have been made to support DDPN students by addressing their individual needs, easing their transition from semester to semester, and providing them with opportunities for enrichment, all of which have led to strong retention rates (Table 3).

Dual Degree Partnership in Nursing Program Retentiona and Graduation Rates

Table 3: Dual Degree Partnership in Nursing Program Retention and Graduation Rates

During Year I, students are encouraged to join the Nursing Learning Community. Those students who take part in the residential portion of the Nursing Learning Community are assigned to two designated floors of a freshman residence hall. Each nursing student is assigned another nursing student as a roommate, but in adjacent rooms reside students who have chosen other majors. Thus, nursing student pairs are intermingled with students in different disciplines to prevent what is known as hyperbonding. This living arrangement allows DDPN students to be one door away or across the hall from one another so they can easily study together and share similar schedules.

For the academic portion of the Nursing Learning Community, all DDPN students take the same section of the freshman advisement seminar required of every student during the first semester at college. Also, they are enrolled in the same Anatomy and Physiology course for the fall (A&P I) and spring (A&P II) semesters. Every year, two junior or senior Biology majors or Year IV DDPN students with excellent records of academic achievement are hired as Study Group Leaders for both semesters of Anatomy and Physiology. These leaders conduct weekly review sessions that cover the classroom and laboratory content of these courses. Although attendance is not mandatory, the DDPN students are strongly urged to participate in these study groups to achieve their academic potential, bond with their peers, and receive mentoring from the more experienced group leaders. Individual tutoring for the biology courses, as well as any of the core courses, is also available at the Academic Support Center.

All DDPN students are assigned a nursing faculty advisor who meets with them on a one-on-one basis regularly throughout the first semester of the freshman year and more often if needed. This advisor remains their primary contact for academic advice and guidance at Le Moyne College throughout all 4 years of the program. Furthermore, the Academic Advisement Center at Le Moyne provides additional support for students if any progression issues arise. Also, during Years II and III of the program, students are assigned a second faculty advisor at St. Joseph’s College of Nursing who helps them with any issues or concerns specifically related to the AD program. During course registration periods, Le Moyne College advisors hold group advisement sessions at St. Joseph’s College of Nursing for the convenience of Year II and Year III students. This is the time when students choose the core courses, which is required each semester, for continuous, smooth, and timely progression. The Chairs of the core departments provide sections of core courses in the late afternoon or evening at Le Moyne College to accommodate the students’ 4-day-per-week schedule of classes and clinical rotations at St. Joseph’s College of Nursing. Advisors are also allowed to preregister the students to be sure they are guaranteed enrollment in the one core course they need each semester.

While attending St. Joseph’s College of Nursing, all DDPN students are on the same class and clinical rotation schedule for purposes of traveling and studying together. However, it is important to note that this common scheduling does not differentiate the DDPN students from those students who are enrolled specifically in the AD program. For example, the clinical groups are a mixture of both DDPN and AD students, as are the clinical laboratory and classroom experiences. Thus, the DDPN students are not isolated as a cohort from their AD peers, and the faculty are not able to readily distinguish between the cohorts.

Regarding tuition assistance, students are eligible for full-time financial aid at Le Moyne College during Years I and IV and for full-time financial aid at St. Joseph’s College of Nursing during Years II and III. Students who are Le Moyne College scholarship recipients can use the monies awarded only when full time at Le Moyne. However, St. Joseph’s College of Nursing offers a variety of scholarships to full-time DDPN students during Years II and III. In addition, eligible students, who agree to work for 3 years of full-time employment at St. Joseph’s Hospital Health Center following graduation from the DDPN, are offered contracts by the hospital to completely cover the cost of tuition and fees during Year III and loan forgiveness of up to $10,000 to cover tuition costs incurred during Year II of the program. Furthermore, students can work per diem or part time throughout the year as Student Nurse Assistants at St. Joseph’s College of Nursing while enrolled in the AD portion of the DDPN. This provides the students with the opportunity to earn some pocket money and to be exposed to the patient care setting in an acute care facility.

Other measures to enhance retention and progression have also been implemented. For those few students who are not successful on the first attempt in a major nursing course at St. Joseph’s College of Nursing, the faculty advisors at both institutions collaborate to adjust the students’ schedules for completion of the DDPN in a timely fashion. In some cases, students have been set back by a semester or two in their progression; nevertheless, all students (with one exception to date) have graduated within a semester or two of their expected date of graduation (Table 3). Also, in the past couple of years, the Department of Nursing at Le Moyne College has offered select BS-level nursing courses in condensed 5-day formats. These courses are delivered during J-mester (January intercession) and May-mester (after the spring semester ends but before summer session begins) for Year III and Year IV students. Completion of these courses helps to reduce the credit load in the last year of the DDPN, and these courses have been well received by the students.

Other attractive initiatives to make course work convenient and accessible include offering select Le Moyne College courses on site at St. Joseph’s College of Nursing campus and the Study Abroad program, which is made available to Year IV students. In January 2010 for the 18 days during the intercession period between fall and spring semesters, students visited the Working Boys Center, established by the Jesuits more than 40 years ago, to care for inner-city families living in poverty in Quito, Ecuador. While abroad, the students completed most of their 45-hour clinical requirements for Community Health Nursing (NSG 440) by engaging in a variety of nursing practice experiences, such as making home visits, working in health clinics, teaching health promotion and disease prevention topics to elementary school children, and assisting in special education classes. They also engaged in service-learning projects, such as helping families build homes or improve their existing dwellings. A second study-abroad opportunity was conducted in January 2012 to Quito, Ecuador. This short-term immersion experience has proven highly valuable in expanding students’ understanding of cultural diversity and the effects of poverty on health and well being. The study abroad program has also proven to be a useful recruitment tool in attracting prospective applicants.

Preliminary Findings

After systematically collecting data over the past 6 years, it is evident that this innovative model is popular with the traditional-age student and is highly successful from an academic standpoint. Applications to the DDPN have increased 175% since the first students were admitted. Furthermore, the total number of students enrolled since the inception of the DDPN has increased by 84% (Table 1).

Students are attracted to the opportunity of earning two degrees in 4 years while experiencing a traditional campus living and learning environment. The reputation of both institutions has undoubtedly been a drawing factor. Le Moyne College, with its strong Jesuit tradition of academic excellence, prepares liberally educated students for service and leadership to society. Its partner, St. Joseph’s College of Nursing, has a prestigious 113-year history of preparing RNs and has been recognized for its high pass rates on the NCLEX for decades. When comparing the NCLEX success of the DDPN graduates with state and national data, DDPN graduates score significantly higher overall than their counterparts in both AD and BS programs (New York State Education Department Professional Education Program Review, 2008–2011).

Despite the rigors of the combined curriculum, retention and graduation rates indicate the feasibility of the model and the potential for students to achieve their goal of becoming a member of the nursing profession and earning their BS in nursing. The most recent Integrated Postsecondary Education Data System report (U.S. Department of Education, National Center for Education Statistics, 2010), which provides the most reliable and valid data on these rates, indicates that our retention and graduation outcomes are comparable to or slightly higher than the norm when measured against other 2-year and 4-year private, nonprofit colleges (Table 3). These benchmarks contribute evidence of the viability of the DDPN.

In examining other factors contributing to the success of the model, by accepting internal change-of-major students to replace those lost through normal attrition in Year 1, each original cohort has been strengthened. Over the past 6 years, data show that the three main reasons for attrition of first-year students are academic failure, withdrawal from college due to economic reasons, and the desire to pursue another major other than the discipline of nursing. However, the internal change-of-major students have proven to be academically successful in their first year of college, are confident in their decision to pursue nursing as a major, and have already demonstrated adjustment to college life. Each group of internal transfers not only has had 100% retention and graduation success but has also achieved a 100% pass rate on NCLEX for first-time takers.

In addition to the quantitative data collected, exit interviews with DDPN students at St. Joseph’s College of Nursing are conducted just prior to graduating from the AD program. These qualitative data have revealed a high level of satisfaction with the DDPN option. For example, when asked “Would you do this program again?” 100% of the DDPN students replied they definitely would. As one student commented: “I’m glad I did it [because] I don’t know if I would have gone back for my BS.” Exit interviews of Year-IV DDPN students at the time of graduation from Le Moyne College also reveal equally positive responses. For example, when asked “How would you rate your overall satisfaction with the program of study?” their comments again were praiseworthy, such as “I would recommend to anyone” and “loved the experience here.”

Conclusion

The evidence gathered over the past 6 years supports the value of this unique partnership. The many aspects contributing to the success of the model have already been addressed, except for the cost. By maintaining the integrity of each curriculum, no additional expenses were incurred other than marketing to make this model a reality. The program created was both an educationally and economically sound approach, resulting in a seamless articulation between two existing programs.

All indicators lead to the conclusion that this model can and should be replicated by other nursing programs nationwide. This curriculum framework, which was developed prior to the recent calls for action (Institute of Medicine, 2011; Benner et al., 2010; Zimmerman et al., 2010) to transform nursing education, has been shared for the purpose of encouraging duplication. This innovative pathway to earning both an AD and a BS degree prepares nurses with competencies necessary for the delivery of safe, quality care in today’s highly complex health care environment.

For institutions interested in adopting this model, the following considerations are recommended:

  • Develop a formal contract with clear, agreed-upon policies.
  • Secure a strong commitment from the administration of both institutions.
  • Cultivate a relationship between the nursing department chairs, which fosters an atmosphere of respect and willingness to negotiate.
  • Ensure that various modes of communication among administrators, faculty, staff, and students are consistent and frequent.
  • Choose to partner with institutions that have similar missions, values, and standards.
  • Collaborate with schools in close proximity to one another.

Given the major changes on the horizon in the U.S. health care system, the need to strengthen the education of nurses, both before and after they are licensed, must occur. Although the entry into practice issue has been widely debated by nurses for more than 45 years, one cannot argue that nurses practicing today require expanded competencies. The 2-year AD curriculum provides an excellent foundation in the basic knowledge and skills for beginning practice, but the limited time frame proves to be a challenge to faculty and students alike in preparing graduates with competencies expected of today’s professional nurse. It is at the BS level that advanced cognitive and psychomotor skills in such areas as leadership, community health, geriatrics, health delivery systems, health assessment, and evidence-based practice are offered. The DDPN model, configured in a 1+2+1 framework, combines the strengths of both levels of education.

Little did we realize when we embarked on this partnership in 2005 that our vision for success would have the potential to contribute to the country’s solution of achieving the Institute of Medicine’s (2011) goal of 80% of BS-prepared nurses by 2020. Without a doubt, both AD and BS programs contribute to the nursing profession; however, together, students experience the best of what both programs have to offer. As Kathleen Potempa, American Association of Colleges of Nursing President, recently declared: “We must think differently and let educational redesign take us where we have never dared to go” (Robert Wood Johnson Foundation, 2011).

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Dual Degree Partnership in Nursing Admission Data for the First 6 Years of the Program

ParameterSemester
Fall 2011Fall 2010Fall 2009Fall 2008Fall 2007Fall 2006
No. of applications receiveda470365302270211171
Completed applications300251230203171131
No. of students acceptedb14090947010990
No. of students denied1019586715239
No. of students enrolledc464143302725
No. of students transferred in66513100
Total students enrolled524748433725

NCLEX® Success of Dual Degree Partnership in Nursing After Graduationa

Cohort Entry (Year)NCLEX (Year)bPass Rate 1st Attempt (%)Pass Rate 2nd Attempt (%)New York State Mean (%)
National Mean (%)
AD ProgramsBS ProgramsAD ProgramsBS Programs
200820119610084.782.787.89.1
200720108710084.384.886.588.7
200620099410085.382.887.689.5
20052008100n/a84.878.886.287.8

Dual Degree Partnership in Nursing Program Retentiona and Graduation Rates

Cohort YearOriginal CohortCompleted Year 1Progressed to Year 2Retention Rate (%)Graduated From AD ProgramAD Graduation Rate (%)bBS Graduation Rate (%)c
2010473839preliminary 83not yet availablenot yet availablenot yet available
200948413675not yet availablenot yet availablenot yet available
2008434236843070preliminary 70
2007373429782568preliminary 73
200625232080166464

10.3928/01484834-20120820-03

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