VUSN’s Pre-Specialty Level of the MSN program is thriving with more than 160 incoming students each year, representing a variety of non-nursing educational backgrounds. After serving as interim director and leading the faculty through a major curriculum revision, Mary Ann Jessee, MSN, RN, became Pre-Specialty director in May 2012. Recently, she sat down with Vanderbilt Nurse.
How would you describe the VUSN Pre-Specialty Level to someone outside the world of nursing?
The Pre-Specialty portion of the MSN program is a three- semester sequence of courses akin to the curriculum of an accelerated BSN for second degree students and very similar to the content included in a typical four semester baccalaureate nursing component from a four-year institution. Students gain knowledge and experience that meet the Essentials of Baccalaureate Nursing, but with a graduate school level of approach and expectation. Upon completion of the Pre-Specialty level, students are prepared to sit for the NCLEX, the National Council Licensure Exam for registered nurses. In addition, our Pre-Specialty educates students to transition directly to the specialty level of the master’s program. Our Pre-Specialty students take 43 credit hours and have more than 700 clinical hours in acute and community settings.
What type of student succeeds in this program?
The rigorous nature of the program works best for a student who is self-motivated, with a significant drive to learn and succeed. GRE scores and grade point averages can tell us a lot about a person’s intellectual ability – and our students rank among the highest in the country. However, students also must make a personal commitment to success. Often it is the goal statements that prospective students write as part of their application process that enable us to recognize career goals and personal attributes that will contribute to their success in this program.
Please describe the current group of Pre-Specialty students.
When I look at the Pre-Specialty student body, I see diversity. There are students from affluent backgrounds and those who grew up with financial hardship. There are those from supportive families and those who have achieved despite having very little support. There are second and third degree students who come with a wealth of life and work experience. There are students from many racial, ethnic and cultural backgrounds. This diversity makes for a very rich learning environment for all of our students. Conversely, within that diversity is a commonality – a passion for improving people’s lives. There is empathy, compassion and a dedication for advocacy for patients, families and communities. These students renew my passion as an educator and a leader. I am excited for the future of this program.
How does it prepare students for the Specialty level of the master’s degree?
While the Pre-Specialty level provides the generalist level of nursing education, we also ensure students have the opportunity to envision how they will apply the nursing concepts in their advanced practice roles. We educate students to address the health status of patients along the continuum of care and through the transitions between levels of care, rather than focusing on one point on the continuum at a time. The Pre-Specialty level educates students to partner with the patient and family to improve health status and health outcomes. Students are engaged in opportunities to develop attitudes of critical thinking, refine skills of leadership and teamwork, and practice professional behaviors that will propel them into their specialty year.
Why is the Pre-Specialty level an important entry point for students?
Our Pre-Specialty level provides a strong, generalist nursing foundation that is essential for function as a registered nurse. This same foundation provides the opportunity for students to make a rapid transition to advanced-practice education. Students are able to build upon their previous baccalaureate education.
Why was it time to revise the curriculum?
Rationale for the revision of our Pre-Specialty Curriculum stems from the recommendations by the National League for Nursing, American Association of Colleges of Nursing, and the Carnegie Center for Teaching as well as our desire to produce students armed with the capacities necessary to enter today’s health care system. Our curriculum needed to reflect the current movement toward competency-based outcome models in nursing education. We have taken these challenges and used them as the catapult for development of a set of outcomes for our Pre-Specialty level that not only meets, but exceeds, the expectations of the AACN Baccalaureate competencies and that prepares our students for the progression to specialty education and advanced practice in nursing. Our goal for this revision was to enhance the student learning experience through the implementation of evidence-based strategies that challenge students to move beyond factual knowledge to a higher level of clinical-judgment. This attention to development of the student’s clinical decision-making processes results in students who are poised to promote and improve the culture of safety in health care and improve patient outcomes.
What are the revisions?
Nursing education has been challenged to “radically transform” our teaching practices to enhance student learning and produce practice-ready nurses, according to “Educating Nurses: A call for radical transformation” study conducted by Benner, Sutphen, Leonard, and Day for The Carnegie Foundation for the Advancement of Teaching. We are responsible for providing sufficient opportunity for students to gain the knowledge, skill, and attitudes needed to provide care that is especially attentive to patient safety needs. To meet those needs, we constructed a curricular framework that focuses on promotion of client-centered care, improved clinical judgment, development of a professional identity, leadership and inter-professional teamwork, and embracing a spirit of inquiry.
We completed an analysis of our courses to identify gaps in content and opportunities for clinical application. We also wanted to pinpoint overlap versus reinforcement of data and learning opportunities. We constructed the curriculum to ensure the foundational concepts essential to the delivery of client-centered care were presented as evident threads throughout coursework. Experiential learning opportunities and evidence-based teaching strategies are interwoven to provide a cohesive and dynamic learning experience for learners with varied learning preferences and of varied age, culture and life-work experience.
How will you measure the impact?
The impact of these curricular changes will be measured with the traditional formative and summative evaluation processes. It is essential that nurses, whether working at the bedside or in advanced practice, have a broad knowledge base, weigh available evidence, and identify patient preferences, and synthesize these concepts to make accurate clinical decisions. Our chief goal is to prepare visionary, forward-thinking yet reflective nurses armed with the knowledge, skill and attitudes needed to navigate the ever-changing health care delivery system.
What attracted you to the Pre-Specialty level of the MSN program as faculty?
VUSN is my alma mater. I believed in the program from the start because it’s how I chose to be educated. I was attracted to the ability to make the smooth transition from baccalaureate education in another field to master’s level studies in nursing. During my years of generalist nursing practice, I reflected on what would have enabled me to be more practice-ready as a new graduate. I wanted to utilize my experiences to provide improved learning experiences to future VUSN students. My years as a faculty member have provided me the opportunity to use my own experiences as a student and as a nurse to make a difference in the educational experience of students.
What did you learn as interim director?
More than anything else, I confirmed what I already knew – we have a team of experienced, talented faculty who are dedicated to asking the hard questions, doing the hard work, and making the often difficult changes that are required to improve student and patient outcomes. Progress can’t be made without the participation and engagement of the entire team. We share a vision for educating future leaders in the nursing profession. We are engaged in continuous evaluation and enhancement of student learning experiences. We strive to continually improve the students’ readiness for nursing practice and transition to their advanced
practice specialty.
Now that you are the director of the Pre-Specialty level, what is your vision?
I envision a success-based educational environment rich with passionate faculty with diverse interests and students eager to embrace new ideas yet willing to advocate for their own. I envision a curriculum that presents rigorous challenge to prepare students for real-world nursing practice. I envision graduates transformed into nurses with exemplary character, dedication to life-long learning, and a passion for improving patient outcomes. We have entered an era of significant opportunity for growth and change in nursing science. VUSN is poised to be a leader in the transformation of nursing education, practice and research.
What have you learned from your students?
Many things. Students bring diverse perspectives to discussions that continually challenge our perspectives as educators. I am always humbled by the volume and quality of contributions made by students to meet needs in their communities and around the globe. I am continually reminded that there are still people with servant-hearts that are dedicated to improving life for others. That is inspiring.
Why did you become a nurse? A teacher?
I’ve always been intrigued by why we do what we do. Is there a better way of doing things? What would be the result of doing something differently? As I began to investigate what I might do with my life, I continued to crave understanding of the rationale behind actions. I came to realize that my pervasive inquiry could be an asset in the nursing profession and could make a difference in the health and wellness of people. Now, as an educator, I continue to ask “why?” but I now have an additional agenda: to examine, create and implement evidence-based teaching strategies to improve the education of the next generation of nurses.
What is it like to be a part of such a transformation year in someone’s life? To see them become nurses?
It’s a remarkable experience. Students enter the program with their own perspectives on life, health and illness, nursing practice, and career goals within the health profession. Over the course of the Pre-Specialty curriculum, students are immersed in experiences that provide new knowledge, challenge their perspectives, and force them to take ownership of their values, beliefs and biases. These experiences foster the development of attitudes of critical thinking including integrity, curiosity and humility, to name a few. Students embrace and display these attitudes at their own pace. The point at which these attitudes become integral to each decision the student makes, signals to us as faculty that the transformation into a nurse has begun.
What do you think the Pre-Specialty curriculum will look like in 10 years?
I envision the Pre-Specialty curriculum as a leader in evidence-based nursing education, evidence-based practice and research. I see this portion of the MSN program and our faculty team as a model for faculty team development. I believe the curriculum will continue to support a thriving diverse student body passionate about making a difference in the lives of patients and families. The implications for community outreach, knowledge development and improvement of patient outcomes are significant. I look forward to the journey.
What do you want everyone to know about the program?
The VUSN Pre-Specialty faculty is dedicated to life-long learning, reflective practice, and continuous improvement of patient outcomes. We engage with students in a facilitative manner that encourages the development of trust-based teacher-learner partnerships. Our innovative, transformative methods produce nurses poised to encourage inquiry, create knowledge, and elevate the significance of nursing practice around the world. We are VUSN.
– Kathy Rivers
Visit nursing.vanderbilt.edu/msn/prespec.html