Faculty in nursing programs for accelerated second baccalaureate degree in nursing (ASBSN) students must examine their teaching strategies. Cangelosi and Moss (2010) reported that many faculty perceived the ASBSN “students as ‘different,’ but few considered different teaching strategies that may be effective with these students” (p. 139). Teaching strategies established for students in traditional programs may not be effective with ASBSN students. Might these unique students (D’Antonio et al., 2010; Walker et al., 2007) expect or need unique teaching approaches and invite faculty change?
This report is the second component of a larger study (Brandt, Boellaard, & Zorn, 2013) and presents ASBSN faculty’s description of their teaching: (a) comparisons of teaching strategies used with ASBSN and traditional (TBSN) nursing students, (b) faculty’s preferred ASBSN teaching strategies and the extent to which they are able to practice those preferences, (c) change in strategies throughout ASBSN teaching experiences, and (d) strategies that promote socialization and professional formation of students and integrate their first degree.
Early literature focused on single-setting ASBSN programs and student characteristics. More recently, scholars have begun to describe approaches that faculty use in teaching ASBSN students, although the studies often primarily focus on the approach rather than students, are frequently anecdotal or based on small sample sizes, and are usually overshadowed by larger curricular or student issues. Nonetheless, characteristics of teaching approaches with ASBSN students have emerged. First, a student-centered focus is valued. Supporting students and appreciating them as adult learners were two best faculty practices identified by ASBSN students (N = 14) in a study by Rico, Beal, and Davies (2010). ASBSN graduates highlighted the importance of faculty showing caring and sensitivity (Cangelosi, 2007). Robert, Pomarico, and Nolan (2011) described how faculty used data from student focus groups to revise teaching strategies. A collaborative learning environment (Hegge & Hallman, 2008) enabled student-centered teaching. The value of collaboration was echoed by Brandt, Boellaard, and Zorn (2012), who related it to three educational theories. Using students’ previous degrees and experiences to help them learn nursing concepts is important (Hegge & Hallman, 2008). ASBSN graduates agreed (Cangelosi, 2007); they valued faculty help in connecting “their previous life experiences with their new nursing experiences” (p. 93).
Second, various specific teaching strategies have been highlighted. For example, several authors cautioned against busy work and redundancy (Cangelosi, 2007; Hegge & Hallman, 2008). Hamner and Bentley (2007) described how to address two nursing concepts with one assignment. Other authors suggested (a) clinical teaching strategies to help students think reflectively and deemphasize content and skills (Lockwood, Walker, & Tilley, 2009), and (b) assignments to enhance critical thinking (e.g., oral and written analyses; DeSimone, 2006). Examples of using technology to expand teaching were also reported (Boellaard, Brandt, Johnson, & Zorn, 2014; Hegge & Hallman, 2008; Piscotty, Grobbel, & Tzeng, 2011; Wilt & King, 2012). Teeley (2007) discussed the effectiveness of a hybrid Web-based course with older ASBSN students who are tech-savvy adult learners.
Some authors described teaching strategies that blend nursing with the humanities. To teach observational skills, Pellico, Friedlaender, and Fennie (2009) found that students were more detailed and fluid in their differential diagnosis after visiting an art museum than individuals in the control group. Similarly, Frei, Alvarez, and Alexander (2010) found that an art education program broadened ASBSN students’ understanding of patient encounters. They noted that “integrating the humanities… advances the objectives of a profession that operates at the intersection of science and art” (p. 676).
The current study extends the growing literature surrounding ASBSN teaching in two major ways. First, it adds depth and breadth by describing factors related to teaching strategies and learning outcomes (e.g., socialization and professional formation). Second, the study goes beyond a single setting, with a sample from a large geographic region.
This descriptive survey collected qualitative data. Institutional review board approval was received and respondents’ confidentiality was protected. All accredited accelerated programs (N = 63) in the 12-state midwestern region of the American Association of Colleges of Nursing (AACN) provided the initial pool for a purposive sample. Eleven states had accelerated programs. Twelve programs were eliminated, as their accelerated programs were not designed for second baccalaureate degree students. From the 51 remaining programs, 25 were randomly selected to serve as the sampling pool (the authors’ university was excluded to avoid any conflict of interest). All eleven states with accelerated programs were represented. Collecting data in multiple sites enhanced the study’s dependability and credibility (Lincoln & Guba, 1985; Polit & Beck, 2012).
In spring 2011, all nursing faculty, academic staff, and administrators in the 25 programs (N = 986) were individually e-mailed the cover letter, with a link to the Accelerated Second Baccalaureate Degree BSN Faculty Experiences Survey (AFES). Designed for this study, the AFES contains 22 demographic and descriptive items and 10 open-ended questions in four domains. After preliminary content validity was determined by the authors, the AFES was pilot tested. Responses to the demographic-descriptive items were analyzed using descriptive statistics. Data from the six open-ended items that comprise Domain Two: Teaching Approach and Domain Three: Facilitating Students’ Professional Development were analyzed for this article. Of the 138 faculty who completed the AFES, 129 met the inclusion criteria. Numbers of responses to each item varied. Response data were cleaned and imported into NVivo 9 software. Software compatibility enabled seamless data transfer, increasing the study’s credibility (Polit & Beck, 2012).
Functions in NVivo 9 were used to analyze data. One author (C.L.B.) read all responses multiple times and coded similar concepts in NVivo 9. The three authors reviewed all codes to achieve consensus on data coding and then collaborated to identify themes. They agreed that a theme would be established if 10% or more of the respondents to an item provided comments that were coded as the same concept. In addition, one comment could support more than one concept and thus contribute to more than one theme.
Several additional strategies enhanced this study’s trustworthiness (Lincoln & Guba, 1985; Polit & Beck, 2012). All methodological decisions made in this study have been carefully documented in an audit trail, with a particular focus on (a) AFES development, (b) sampling, and (c) data analysis. This documentation enhanced the confirmability and the dependability of the study. In addition, two or more researchers (C.L.B., M.R.B., C.R.Z.) were involved in all data collection and analysis decisions; this investigator triangulation further strengthened the study’s confirmability and credibility.
Most of the respondents were women (93%) and Caucasian (95%). Eighty-three percent had taught 6 years or less in an ASBSN program. Fifty percent were aged 51 to 59 years; 61% held master’s degrees and 38% held a doctorate degree. Seventy percent (n = 90) had substantial experience teaching in both ASBSN and traditional BSN nursing programs. Eighty-five respondents indicated a teaching preference: 46% (n = 39) preferred ASBSN, whereas 54% (n = 46) preferred TBSN. Findings about ASBSN teaching experiences are summarized in the Table. It includes (a) a list of topics and the number of faculty who responded to each topic, and (b) themes that emerged in each topic and the number of respondents supporting each theme.
Teaching Experiences in Accelerated Second Baccalaureate Degree (ASBSN) Nursing Programs: Topics and Themes
Respondents were asked to describe similarities and differences in their teaching experiences in the ASBSN program and the TBSN program. Responses emerged in two groupings: programs and students (Table).
Content and courses emerged as the only program similarity. Respondents identified similar content, courses, books, examinations, and the “same massive amount to learn” in both programs; one respondent noted “it’s the same material but just at a faster pace.” Pace was the single theme that emerged as a program difference. ASBSN programs were described as condensed and faster paced, with shorter time frames. One respondent stated, “In the ASBSN program, I only have a summer course (8–10 weeks) to teach them fundamentals…that I teach over two semesters in the traditional program.”
Knowledge of Nursing was the single theme that emerged as a similarity between ASBSN and TBSN students. Students in both programs were portrayed as “novices in nursing knowledge” and they both “require the skills specific to nursing.”
Six themes emerged indicating differences between students in the two programs. Respondents described ASBSN students as demonstrating a higher level of (a) Maturity, (b) Life Experiences, and (c) Learning Behaviors. The following respondents’ comments demonstrate those themes, respectively: accelerated students (a) “are more fun to teach because of their relative maturity,” (b) “have more experience in the ‘real world’ and bring richness of previous student experience,” and (c) “ask more probing questions during class and clinical, which encourages me to further explain concepts.”
By contrast, respondents’ views differed on students’ Commitment, Motivation, and Engagement in Outside Activities. Many respondents (n = 10) reported that ASBSN students demonstrated a higher level of commitment (e.g., “the accelerated students are so committed. They realize that [they] have just a year to complete…and they are giving it all they got to learn as much as they can”). However, one respondent reported that TBSN students are more committed and two reported there is no difference in student commitment.
Similarly, many respondents (n = 11) reported that ASBSN students demonstrated higher levels of Motivation (e.g., “They are enthusiastic and motivated to find ways to apply this new knowledge.”). However, three respondents reported that TBSN students were more motivated, and six reported there were no differences in students’ motivation.
Finally, respondents appeared divided in their perception of students’ Outside Activities (e.g., social, extracurricular, work, family). Three respondents indicated that ASBSN students had more outside activities, four indicated that TBSN students had more, and five indicated that students in both groups were engaged in outside activities.
When respondents were asked to describe the teaching approaches they preferred to use with ASBSN students, four themes emerged (Table). First, Appreciate the Adult Learner With Previous Experiences was demonstrated by the following respondent comments: “I like to acknowledge their backgrounds, both work and life experiences, and how those backgrounds enhance their learning” and “respect them and their previous experiences, whatever that may be.” Collaborate with a Prepared and Actively Engaged Student emerged as a second theme. One respondent stated, “I ask them to trust me enough that I know the ‘big picture’ and they do not. They have to believe that I will give them what I think they need to know.” Another said, “Very quickly you become more of a resource person rather than one who constantly watches [and] assists the students.”
A third theme emerged: Integrate Lecture, Discussion, Case Studies, Experiential Learning, and Small-Group Activities. This theme was demonstrated by the following comment:
Small-group discussion, experiential learning, clinical practicum, role-play—much of this is based in my psychiatric-mental health perspective, not just because the students are accelerated but they do seem to adopt this…learning more quickly.
Embrace Technology to Enhance Teaching and Learning emerged as the fourth theme. A variety of technology was used, including movie clips, games, i>clickers®, texting, simulations, online assignments and discussion, wikis, and podcasting.
Many respondents (n = 69) used quantifiable terms in replying to the question, “To what extent are you able to practice your preferred teaching approach and/or strategies when teaching ASBSN students?” Ninety percent indicated they were able to do so most of the time or always. One respondent stated, “We have complete freedom to design and deliver our course content and use whatever teaching approaches or strategies we want to use.”
Three themes emerged when respondents were asked, “How have your teaching approaches and/or strategies changed throughout your ASBSN teaching experience?” (Table). Some respondents indicated no change. Comments from others supported the second theme, Incorporated More Technology. One respondent said, “Technology has changed things a lot”; others indicated that students can go online and review procedures, look up medications and diseases, and write and deliver evaluations. Another said, “I have begun course casting lectures, but not sure if this helps or not. The students ‘like’ it, but I like chocolate ice cream, too.”
Increased Student Engagement emerged as a third theme. One respondent stated, “I still use the same strategies but have increased the level of class participation simply because they respond well when asked questions.” Another respondent reported, “Slowly I am working on more interaction, rather than lecture,” and another said, “When I first started teaching, I was more of a mother hen…. I have become more relaxed…and I have more dialogue with them.”
Noting the compressed time frame of ASBSN programs and the nontraditional status of the students, respondents were asked to describe strategies they used to promote the socialization and professional formation of the students. Five themes emerged (Table). The first theme, Role Model Professional Nursing, is an approach that requires direct and explicit faculty action. One respondent stated, “Seeing and doing and feedback…are the most effective means.” Another said, “I try to help them learn the identity of the nurse by talking about the role models or clinical examples of professionalism they see in clinical staff.”
In the other four themes, promoting socialization and professional formation requires an active, engaged student. Numerous examples supported the second theme, Connect Students with Structured Professional Activities. Students participated in nursing student organizations, professional meetings, honor societies, and local conferences.
Facilitate Interactive Student Discussions emerged as the third theme. Respondents reported that they “frame discussions from the standpoint of what it means to think like a nurse” and “increased communication among students—comparing what they did in their previous ‘life’ and what is going to be different now.” The fourth theme, Integrate Group Work, was supported by the following comments: (a) “Group presentations help the student live through the experience of working together, facing their peers and trying to communicate an idea” and (b) “I foster ‘team work’ early on…. It is difficult to succeed without working together, as the ‘best patient care’ sometimes is accepting and trying new ideas that will work for each patient.”
Support a Relationship-Based Group Identity emerged as the final theme. One respondent stated, “The accelerated [students] stay very closely knit with their cohort.” Another said, “They know what they need—our job…is to provide the right environment and support for them.”
When respondents described strategies they used to integrate students’ first degree, two opposing themes emerged: (a) I Don’t, or I Don’t Because and (b) I Do, and Let Me Tell You How (Table). Demonstrating the first theme, one respondent reported, “I don’t believe we do this AT ALL.” Others provided reasons they did not, which included a lack of time, the first degrees are too varied, the classes are too large, little correlation exists between the first degree and nursing, and faculty in other courses take on this responsibility.
In contrast, other respondents described various strategies to help students integrate their first degrees. Faculty provided numerous examples:
- [If a student was a “dietetic” major,] I try to have them include that knowledge in doing a dietary assessment. For a student with a previous engineering degree, I would ask how they might redesign a nursing work station. For a student with a [bachelor’s degree] in psychology, I would ask for them to apply psych concepts to the [medical–surgical] patient.
- A Hospitality and Tourism degree is easily integrated into “customer service” in nursing.
- [A former optometry assistant] supplemented my lecture and helped her peers with the hands-on application.
Finally, respondents provided additional observations about their ASBSN teaching experiences. Although this item fell at the end of a lengthy survey, 36 faculty responded. Nearly one third of the faculty supported the single theme that emerged: I Like It, I Love It, I Enjoy the Challenge of It (Table). Respondents said, “I relish the challenge they [students] provide to my teaching, they keep me on my toes!” and “Teaching ABSN is some of the most gratifying work I’ve ever done.” Another said “Be prepared to live it 24-7-365…. You either love it or hate it. I happen to love it.”
A large sample from a broad geographic area provided varied and richly detailed data about ASBSN teaching. Consistent with findings from the first component of this study (Brandt et al., 2013), themes in this analysis also indicated that ASBSN students are motivated and engaged in their learning. Data analysis in both study components confirmed challenges associated with ASBSN programs’ fast pace.
Sometimes there is a perception that accelerated nursing education does not meet the same standards as traditional education. Bowie and Carr (2013) indicated that:
anecdotal reports by…students have highlighted some of the barriers to effective mentoring when staff nurses…make comments such as “I don’t think it is possible to become a competent nurse in a fast track program.”
However, in the current study, respondents reported important similarities that sometimes may be overlooked. Specifically, the Content and Courses theme emerged as a program similarity. This finding is crucial because faculty, administrators, and clinical agency staff may negatively perceive an accelerated program as an “abbreviated” program, with trimmed content and fewer courses. As an indicator of ASBSN program quality, comparable content and courses are significant as (a) faculty seek support from health care agencies for clinical placements and other education–practice partnerships, (b) administrators make resource decisions, and (c) graduates pursue employment.
Although it is widely published that ASBSN students are adult learners with a broad range of educational and experiential backgrounds, it is critical to remember that their Knowledge of Nursing is similar to students in traditional programs. This similarity has not been explicitly reported in earlier literature. Awareness of the similarity may help faculty to avoid the halo effect, which is a bias that sometimes affects researchers’ use of rating scales. That is, faculty must be vigilant so they are not unfairly influenced by what they perceive as positive student characteristics (e.g., previous degrees, life experience, older age) as they make judgments about students’ performance. Thorough and accurate assessment further contributes to the quality of ASBSN education.
Citing numerous descriptions of programs and ASBSN students, Huckstadt (2012) maintained that “different teaching and learning strategies are needed for the diverse learners in accelerated programs” (p. 66). Newton and Moore (2013) found that ASBSN students had higher critical thinking scores than TBSN students during the first month of the curriculum, which further supports the need for different strategies. Despite a call for different teaching strategies in ASBSN programs, Millett (2013) reported an early finding that indicated greater difference in teaching strategies between ASBSN programs than between accelerated and traditional programs.
Respondents in this study reported using a number of specific teaching strategies, emphasizing discussion, problem solving, and group work. They did not indicate that these approaches differed from those they used with traditional students; they reported these only as approaches they preferred to use with ASBSN students.
A novel contribution to the understanding of ASBSN education is the respondents’ integration of the students’ first degrees. Nearly half of the respondents to that item provided examples. Their attention to the diversity of first degrees and their intention to integrate the knowledge gained in those degrees are noteworthy. It follows then, because these faculty recognize that ASBSN students differ from TBSN students, that they do modify their teaching approaches in this aspect of their teaching. Additional study is needed to determine the extent to which teaching strategies differ between the two programs.
Consistent with trends in higher education overall, respondents in the current study indicated that they use technology as a preferred teaching approach and have increased their use of technology over time. Faculty are not avoiding high-technology teaching strategies simply because more of the ASBSN students may be older or less tech savvy. In fact, Millett (2013) reported that ASBSN faculty are more likely to use technology than faculty teaching traditional students. Referring to ASBSN students, Huckstadt (2012) stated that “more sophisticated, realistic technology is valued by adult learners” (p. 75). Not only do ASBSN students value technology, they expect teaching “to be infused with instructional technology” (Bowie & Carr, 2013, p. 396).
Despite the trend to use more technology over time, 16 (17%) of 93 respondents reported no change in their teaching approaches. Previous survey items may have skewed respondents toward a comparison between ASBSN and traditional teaching approaches, rather than a longitudinal assessment of their ASBSN teaching approaches. However, if faculty actually did not change their ASBSN teaching approaches over time, questions emerge. What factors contribute to faculty retaining earlier approaches without revision? Is the length of teaching experience linked to faculty change in teaching? What methods and tools are being used to evaluate teaching effectiveness?
It is heartening that the majority of faculty in the current study use their preferred teaching approaches with ASBSN students. Assuming that this ability contributes to job satisfaction and faculty receive support for their teaching preferences from colleagues, nursing administration, and the university, this finding could be helpful in recruiting new faculty. Respondents also described ASBSN students as being prepared. Although “prepared” is open to various interpretations (e.g., reading before class, completing homework, awake and rested, positive attitude), it may be that because the students are actively engaged and prepared, faculty feel encouraged and more free to use and experiment with a variety of teaching approaches that require more student participation.
In a fast-paced program in which there is too little time and too much work for students and faculty (Brandt et al., 2013), socializing students to the profession is a unique challenge and “critical to becoming a nurse professional” (Bowie & Carr, 2013, p. 395). Socialization and professional formation require time and reflection in ways that are different from performing procedures and developing clinical decision-making skills. Faculty in the current study did not neglect this element of baccalaureate education.
When respondents were asked to describe strategies they use to promote the socialization and professional formation of students, two themes emerged related to being part of a student group: Integrate Group Work and Support a Relationship-Based Group Identity. The authors recognized that some respondents interpreted this survey item to refer to students socializing with each other, rather than being socialized into the nursing profession (the latter was the authors’ intent). However, the emergence of these two themes demonstrates the value faculty place on students socializing with each other and forming a group identity. Faculty in this study assumed responsibility and actively intervened with planned strategies to enhance personal connectedness within the student group.
The value of socialization is widely applicable to various professional groups. For example, Hessler and Ritchie (2006) identified the need to foster socialization as one of 10 suggestions for schools of nursing to consider when recruiting and retaining faculty. It may be a key component of socialization into the profession and professional formation is seeing oneself as a member of a group. That is, if students are expected to be a contributing member of the discipline (i.e., a nurse–citizen), practicing being a student–citizen is extremely worthwhile, perhaps essential.
Implications for further research focused on sample selection and instrument revision have been identified (Brandt et al., 2013). Related research areas also merit careful study. Examining the effectiveness of specific teaching strategies used with ASBSN students would contribute to an evidence-based approach to teaching these students. In addition, what is the relationship between teaching effectiveness and competent ASBSN graduates who become leaders in nursing? To what extent are teaching effectiveness assessment methods valid and helpful to new and veteran faculty? Finally, investigating ASBSN education issues as they pertain to faculty recruitment and retention is vital.
Although the current study’s strengths include its large sample size, wide geographic representation, and electronic data collection, several limitations also exist. Only initial content validity of the AFES was established. Unclear item wording (e.g., socialization, approach and strategy) may have resulted in interpretations that shaped the responses in unique and unknown ways. Further, as described in Brandt et al. (2013), a survey response rate of individuals who met the inclusion criteria could not be calculated; a broadcast invitation was sent to all listed faculty on each program Web site, and respondents participated based on their self-identification as having substantial ASBSN teaching experience.
In heeding the ASBSN faculty voice, a major implication is faculty development. Rideout (2012) maintained that “recruitment and retention of excellent faculty to teach in an accelerated nursing program and their ongoing development is critical to ensure continued success of these programs” (p. 159). Results from this study invite nurse educators and administrators to examine critical day-to-day issues about teaching—teaching that is shaped by unique students, programs, and faculty experiences and emotions. Because of resource limitations or a lack of familiarity with teaching issues, nursing and university administrators may minimize, misunderstand, or ignore aspects of ASBSN education. Yet, it is insightful leadership surrounding these facets at all levels that is central to faculty recruitment, development, and retention.
Not only are students in fast-paced, innovative ASBSN programs inviting faculty change, they are depending on faculty who are open to change and administrators who are effective leaders. Both are vital to support students’ success and their meaningful contribution to a health care system in fast forward.
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Teaching Experiences in Accelerated Second Baccalaureate Degree (ASBSN) Nursing Programs: Topics and Themes
|Topics (No. of Respondents)||Theme (No. of Respondents)|
|Similarities and differences in teaching experiences in ASBSN and traditional baccalaureate nursing programs (n = 80)|
| Program similarity||Content and Courses (n = 12)|
| Program difference||Pace (n = 10)|
| Student similarity||Knowledge of nursing (n = 9)|
| Student differences||Maturity (n = 18)|
|Life experiences (n = 12)|
|Learning behaviors (n = 12)|
|Commitment (n = 13)|
|Motivation (n = 20)|
|Outside activities (n = 12)|
|Preferred teaching approaches with ASBSN students (n = 104)||Appreciate the adult learner with previous experiences (n = 10)|
|Collaborate with a prepared and actively engaged student (n = 22)|
|Integrate lecture, discussion, case studies, experiential learning, and small-group activities (n = 61)|
|Embrace technology to enhance teaching and learning (n = 14)|
|Extent faculty are able to practice preferred teaching approaches (respondents who used a quantifiable term, n = 69)||Always (n = 38)|
|Most of the time (n = 24)|
|Minimally (n = 7)|
|Change in teaching approaches throughout ASBSN education experience (n = 93)||No change (n = 16)|
|Incorporated more technology (n = 12)|
|Increased student engagement (n = 21)|
|Strategies to promote socialization and professional formation of ASBSN students (n = 86)||Role model professional nursing (n = 11)|
|Connect students with structured professional activities (n = 12)|
|Facilitate interactive student discussions (n = 12)|
|Integrate group work (n = 25)|
|Support a relationship-based group identity (n = 25)|
|Strategies to integrate students’ first degree (n = 86)||I don’t, or I don’t because (n = 14)|
|I do, and let me tell you how (n = 39)|
|Additional observations about ASBSN teaching Experience (n = 36)||I like it, I love it, I enjoy the challenge of it (n = 11)|