Judith P. Ruland PhD RN
Diane Wink EdD RN

It has now been almost a decade since the evolution of community based nursing education (CBNE) programs. When CBNE was first developed, the PEW commission (1991) had widely published predictions that there would be an oversupply of registered nurses in acute care settings by the year 2015 and therefore suggested that nursing education programs needed to shift their preparation focus to CBNE because that is where the majority of graduates would be working. That original prediction is no longer correct as nursing is in the midst of the worst nursing shortage in over forty years. Ninety-eight percent of all new graduates from all levels of educational programs elect to practice in hospitals in the acute care arena for at least one year after graduation (del Bueno, 2002). While there has been much published about the benefits of CBNE and the need for change toward CBNE, much less work has been done in the area of the assessment of measurable outcomes that would demonstrate the effectiveness of CBNE. The work that has been done has primarily been measuring the effectiveness of CBNE graduates to function in the expanded nursing roles that CBNE is designed to develop. There are no studies that report the effectiveness of CBNE when the graduate enters the highly technical, high acuity reality of hospital nursing in the face of this severe shortage.

This study will seek to compare the graduates of CBNE nursing curricula with those from traditionally styled baccalaureate generic curricula on a number of standardized measures of educational outcomes. Five measures will be used during the pilot study including (1) a multiple choice test of minimal knowledge base necessary for licensure (HESI Exit exam), (2) a survey related to how well prepared the student feels he/she was in terms of the AACN essential Baccalaureate behaviors (Educational Benchmarking Incorporated Exit Survey), (3) a survey measuring self-efficacy in terms of clinical skill called the Clinical Skills Self-Efficacy Measure (CSSE, Owen, Froman, & Hand, 2003) and (4) a survey measuring the 17 attitudes described by the Pew Commission as being essential to nursing called the Attitudinal Survey of Beliefs Related to Professional Nursing Competencies or the BRPNC (Simoni, 1996). In addition to those four measures, a randomly selected subgroup of 40 students at each school will be tested with an individualized system designed to assess and validate nurses and other health care professionals’ ability to meet competency expectations called the Performance Based Development System, PBDS (del Bueno, 2001). This study will provide data that looks at outcomes of community-based versus traditional curricula in the context of acute care settings, and will add to the body of knowledge related to nursing education. It will be the planning basis for a national, multi-site, multi-method project to be conducted at the conclusion of the pilot study.

This study addresses several of the NLN research priorities in nursing education. These include the first priority, which is Competencies Of Nursing Graduates For 21st Century Practice. Within this category the element best described by this study is the definition and validation of nursing programs designed to meet the needs of the public. The importance of validating that CBNE is an appropriate method of nursing education in these shifting sands of educational and health care priorities is extremely important for the future development of nursing curricula. The next research priority addressed by this proposal is Resource Accountability Models of Educating the Nursing Workforce. Within that category the subcategory of benchmarks for accountability and effectiveness is an obvious choice based on the kind of measures being used in the study, the HESI, the PBDS, and the EBI are all nationally used exams and are capable of demonstrating to the participating institutions in what areas they fare well and which areas need their attention for improvement. Finally the last priority that is well suited to this study, Research-based paradigms, strategies, and Evaluation Models For Nursing Education. Within this category, the sub category of evaluation of new pedagogies for nursing education, including clinical education and Evaluation of teaching and learning outcomes is most appropriate.