The lived experience of a nurse begins with a sound academic foundation that includes science and math, addressing individual biases, understanding a variety of cultures, and, most importantly, experience. Many nurses have taken the non-seamless academic progression into nursing, which involves various educational routes or entry levels. Entry levels into nursing may include a Bachelor of Science in Nursing (BSN), Associate’s Degree in Nursing (ADN), Licensed Practical/Vocational Nurses (LPNs/LVNs), and Diploma in Nursing.
Why have so many chosen one or more of these pathways to reach their goal of becoming a registered nurse (RN)? Multiple factors may lead someone to select a particular entry-level, such as family obligations, educational costs, or limited seats within the nursing program. Even with the multiple entry levels into practice, the goal to increase BSNs in healthcare still needs to be met (Overholster, 2023). This post will briefly share a DNP/Ph.D. perspective on seamless academic progression for nurses as reflected in the National Academy of Medicine’s key message two, Nurses Should Achieve Higher Levels of Education and Training Through an Improved Education System That Promotes Seamless Academic Progression.
Seamless Academic Progression
The growth of the nursing workforce depends upon seamless academic progression. Seamless academic progression allows an RN to obtain a BSN or MSN. Many hospitals/acute care settings require or prefer the baccalaureate degree nurse for various nursing roles to receive MagnetⓇ recognition. Examples of nursing programs that promote academic progression are LPN-to-BSN, RN-to-BSN, and ADN-to-MSN, providing a significant pathway to advanced practice nursing and faculty positions at the college level. Master’s degree-prepared nurses are knowledgeable clinicians, clinical healthcare leaders, members of academic institutions, health policy creators, and researchers.
Nursing leaders, including multi-generational students, must consider multiple factors when encouraging seamless academic progression. For example, nursing schools must innovate programs to meet learner outcomes through various methods and technologies. The learners may need various ways to meet competency, including low and high-fidelity learning experiences. Academic progression occurs as a result of not only meeting individual learning needs but also considering those previous lived experiences that may impact their approach to learning. Therefore, ensuring this is also met in the practice setting as the nurse’s transition is critical to the ongoing retention of nurses in the workforce (Groski et al., 2019).
Experiential Theory/Models
Kolb’s Experiential Learning Theory defines the process by which knowledge is created as the transformation of experience. Experiential learning can be widely used to transition nurses to practice, especially those entering nursing as a second career. The legendary novice to expert theory aligns closely with experiential learning, recognizing that an individual develops by encountering situations to enable them to adjust to the social environment and adapt skills before they can progress to the next stage of practice (Benner, 2000; Graf et al., 2020).
The American Association of Colleges of Nursing (AACN) released the updated Core Competencies for Professional Nursing Education in 2021, which provides a framework for nursing practice and applied experience (2021). Ten domains with sub-competencies are listed and must represent nursing practice, supporting competency-based education. Competency-based education is outcomes-focused and builds on what the learner already knows and what is expected of the learner (Barnes et al., 2023; Gidden et al., 2022). With the ever-changing technology and innovation, this model is supported to facilitate seamless academic progression as the healthcare landscape evolves.
Patient Outcomes
The IOM report (2011) cited evidence that a higher proportion of BSN-prepared RNs in the workforce improves patient outcomes. Many nursing leaders understand that nursing is often a second career choice for some nurses, indicating that nurses enter the profession with baseline knowledge of human experience, customer service, and/or financial acumen. Research has shown that lower mortality rates, fewer medication errors, and positive patient outcomes are all linked to nurses prepared at the baccalaureate and higher degree levels. A more significant proportion of professional nurses at the bedside has been shown to improve patient outcomes for patients and staff (Aiken et al., 2017; Davis, 2012). Reducing barriers, such as the nursing skill mix, by adding assistive personnel without professional nurse qualifications, may contribute to preventable deaths, erode care quality, and nurse shortages (Angel, 2020).
As health care continues to shift to a population-focused, community-based approach to care, the health system needs RNs who can practice across multiple settings and function to the fullest extent of their license. Employers today seek nurses capable of providing high-quality direct care, complex clinical decision-making, care transition management, supervision of support personnel, guidance of patients through the maze of healthcare resources, and educating patients on treatment regimens and adopting healthy lifestyles. Moving nurses further along the educational continuum will help to ensure that RNs are well-prepared to meet these expectations.
Student Nurse Experiences
Providing the accelerated format and program outcomes in advance will better prepare our workforce to enter into expedited programs.“I am concerned about simply being in an accelerated program because this will differ greatly from my first degree” – Isabel, a female student, age 22, who majored in social and applied sciences (Davis, 2012). This is one example of ensuring that the expectations and models are provided to students across all generations. Many students entering nursing now have an undergraduate degree or work experience in another profession. The experience and prior degree supports moving these students through an accelerated process. However, some students accepted to these programs have yet to gain a previous degree or work experience.
Call to Action
Nursing education should serve as a platform for continued lifelong learning and include opportunities for a seamless transition to higher degree programs (AACN, 2016). Increasing the number of RNs in the nursing workforce can be accomplished by seamless academic progression. Facilitators that may promote seamless academic progression include financial incentives from healthcare institutions, flexible work schedules that will allow nursing students to provide for their families, and an understanding of the positive impact RNs have within the healthcare workforce. Healthcare leaders must understand the meaning of seamless academic progression, support nursing programs that provide seamless academic progression, and provide opportunities for seamless academic progression models across universities (Angel, 2020).
Authorship
Amanda Garey, Ph.D., RN, NPDA-BC, EBP-C
Assistant Professor
University of Texas Medical Branch School of Nursing
1100 Mechanic St, Galveston, TX 77550
Email: amgarey@utmb.edu
Sharisse A. Hebert, DNP, APRN, FNP-BC
Assistant Professor
Prairie View A&M College of Nursing DNP Program Coordinator
6436 Fannin St, Houston, TX 77030
Phone: (713) 797-7050
Email: sahebert@pvamu.edu
References
Aiken, L. H., Sloan, D., Griffiths, P. et al. (2017). Nursing skill mix in European hospitals: association with mortality, patient ratings, and quality of care. BMJ Quality & Safety, 26(7), 559-568. https://doi.org/10.1136/bmjqs-2016-005567
Angel, L. (2020). Best practices and lessons learned in academic progression in nursing: A scoping review. Journal of Professional Nursing, 36(6), 628-634. https://doi.org/10.1016/j.profnurs.2020.08.017
American Association of Colleges of Nursing (AACN). (2024 May 8).Academic Progression in Nursing: Moving Together Toward a Highly Educated Nursing Workforce. Position Papers and White Papers. https://www.aacnnursing.org/news-data/position-statements-white-papers/academic-progression-in-nursing
American Association of Colleges of Nursing (AACN). (2024 April 7). The Essentials: Core Competencies for Professional Nursing Education. AACN Essentials. https://www.aacnnursing.org/essentials
Barnes, R., Remick, J., Hughes-Gay, M., Opsahl, A., Townsend, C., Lash, R., & Ellis, R. J. B. (2023). The AACN Essentials journey. Journal of Professional Nursing, 46, 19-26. https://doi.org/10.1016/j.profnurs.2022.11.010
Benner, P. (2000). From novice to expert. Pearson.
Davis, D. (2012). A seamless progression: Preparing accelerated second degree nursing students for entry into baccalaureate and masters nursing education. Journal of Doctoral Nursing Practice, 5(1), 6. https://www.proquest.com/scholarly-journals/seamless-progression-preparing-accelerated-second/docview/1011059328/se-2
Graf, A. C., Jacob, E., Twigg, D., & Nattabi, B. (2020). Contemporary nursing graduates’ transition to practice: A critical review of transition models. Journal of Clinical Nursing, 29(15-16), 3097-3107. https://doi.org/10.1111/jocn.15234
Gorski, M. S., & Polansky, P. (2019). Accelerating progress in seamless academic progression. Nursing Outlook, 67(2), 154–160. https://doi.org/10.1016/j.outlook.2018.11.008
Giddens, J., Douglas, J. P., & Conroy, S. (2022). The revised AACN essentials: Implications for nursing regulation. Journal of Nursing Regulation, 12(4), 16-22. https://doi.org/10.1016/S2155-8256(22)00009-6
Overholser C. D. (2023). Seamless academic progression in nursing education: A qualitative descriptive study. Nursing Education Perspectives, 44(4), 205–209. https://doi.org/10.1097/01.NEP.0000000000001109