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Discussions between clinical nurse leaders and nurse faculty regarding changes in healthcare that affect the new Bachelor of Science in Nursing (BSN) graduate resulted in the creation of the Senior Partnership Practicum. This article describes the process that took place to implement this clinical partnership model at Johnson City Medical Center (JCMC).

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RN-BSN students enrolled in a clinical course often have limited or no interaction with other students within the course due to geographic distance and individual preceptor assignments. Learning is often restricted to a student and his/her preceptor and instructor. Geographic and physical distance factors inhibit a student's perception of connectedness and learning. Interdependent interaction between peers, the instructor, and the professional community may increase student achievements and enhance a sense of connectedness. The purpose of this study was to assess the effects of an Interdependent Conferencing Activity (ICA) in an online clinical conference on RN-BSN students' Psychological Sense of Community (PSOC). Students' perception of learning and connectedness are the secondary outcome measurements for PSOC. The ICA was developed to promote interdependence and interaction to enhance PSOC. The research supports the hypothesis that implementation of an ICA will increase PSOC in RN-BSN students in the intervention group when compared to the control and comparison group in an online clinical conference. An experimental, pre-test, post-test research study was conducted to test the hypothesis that implementation of an ICA will increase PSOC in RN-BSN students in the intervention group when compared to the control and comparison group in an online clinical conference. RN-BSN students enrolled in their clinical practicum course (two sections over two semesters) were recruited to participate at the beginning of the course. Each of the sections had a web component. Those who consented to participate were randomly assigned to one of three groups: control, comparison, or intervention. The control group responded to focused questions; the comparison group answered questions related to the application of knowledge gained within their practicum experiences; and the intervention group responded to inquiry about the same theoretical concept from the perspective of their total professional experience, citing examples to support or change evidence-based practice. The Classroom Community Scale (CCS) developed by Rovai (2002c) for use in online course assessment was administered at the beginning and end of the course to measure PSOC and its subscales of learning and connectedness. A total of 67 students participated (control n = 20, comparison n = 22, intervention n = 25). The majority of subjects were female (91%) and Caucasian (83.6%). Their average age was 31.4 years and they had an average of 6.4 years of experience as an RN. With the exceptions of years of experience, demographic characteristics were similar for each group. There was a significant difference for PSOC among the groups (RMANOVA; p = >.001). Post hoc analyses indicated a significant difference in the total PSOC and the subscales of Connectedness and Learning between the experimental group and both the control and comparison groups. Implementation of an ICA enhanced PSOC in an online RN-BSN online conference. The development and implementation of the intervention supported the research hypothesis, the 21st Century educational factors, and the use of experiential learning in the profession of nursing. This research addressed two critical gaps in literature: a paucity of research available on clinical conferencing in nursing, and clinical conferencing within the RN-BSN population. The ICA is an action that could easily be implemented in online conferencing.

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Predicting retention and time to graduation within accelerated online and a hybrid RN-to-BSN programs are significant elements in leveraging the pipeline of qualified RNs with BSN degrees, but the literature lacks significant accounts of retention and time to graduation outcomes within these programs and predictive algorithm developments to offset high attrition rates. The purpose of this study was to quantitatively examine the relationships between pre-entry attributes, academic integration, and institutional characteristics on retention and time to graduation within accelerated online RN-to-BSN programs in order to begin developing a global predictive retention algorithm. This study was guided by Tinto's theories of integration and student departure (1975, 1984, 1993) and Rovai's composite persistence model. Retrospective datasets from 390 student academic records were obtained. Findings of this study revealed pre-entry GPA, number of education credits, enrollment status, 1st and 2nd course grades and GPA index scores, failed course type, size and geographic region, admission GPA standards, prerequisite criteria, academic support and retention methods were statistically significant predictors of retention and timely graduation (p <.05). A decision tree model was performed in SPSS modeler to compare multiple regression and binary logistic regression results, yielding a 96% accuracy rate on retention predictions and a 46 % on timely graduation predictions. Recommendations for future research are to examine other variables that may be associated with retention and time to graduation for results can be used to redevelop accurate predictive retention models. Having accurate predictive retention models will affect positive social change because RN-to-BSN students that successfully complete a BSN degree will impact the quality and safety of patient care.

Nursing leaders have called for more bachelor-of-science-in-nursing-(BSN)-prepared nurses to meet workforce demands. There is limited capacity in BSN programs to meet the projected demand. Currently, associate degree in nursing (ADN) programs produce the majority of registered nurses. To increase the number of BSN graduates, nurse educators recommend innovative educational models for seamless progression from the ADN to the BSN. Concurrent enrollment ADN-BSN programs offer one potential model to produce more BSN graduates. The purpose of this study was to describe the process of developing and implementing concurrent enrollment ADN-BSN programs. The research question was as follows: What is the experience of nurse educators in developing and implementing concurrent enrollment ADN-BSN completion programs? The method of inquiry was a generic qualitative descriptive study. Seventeen participants were recruited from concurrent enrollment programs across the country. Data collection occurred through semi-structured email interviews. The data was manually coded using holistic, descriptive and in vivo coding methods and then analyzed using situational mapping for similar patterns and thematic concepts. There were five conceptual themes that described the process of developing and implementing concurrent enrollment ADN-BSN programs. The five themes emerged as championing the program, establishing partnerships, predicting student success, promoting student success, and adapting to change. The implications to nurse educators are a better understanding of an innovative educational model to produce more BSN graduates. More BSN graduates benefits the nursing profession. Further research is needed to understand the benefits and drawbacks of concurrent enrollment programs and the factors that influence adoption of this educational model.

While the development of online education has been progressing rapidly, further evaluation research is needed (Atack and Rankin, 2002; Halter et al., 2006). There is a need for further research on nursing students' experiences and satisfaction with online education, and correlating factors to promote the quality of online learning. Social presence is one factor that has been shown to affect outcomes such as satisfaction and perceived learning in online courses (Gunawardena and Zittle, 1997). <br>The purpose of this study was to assess social presence in online nursing courses and its relationship to student satisfaction and perceived learning. The theoretical framework for the study was the Framework for Assessing Outcomes in Web-based Nursing Courses (Billings, 2000). A descriptive, correlational study design was used. The study instrument was a 34-item questionnaire administered via the Internet and consisting of the Social Presence Scale and the Satisfaction Scale (Gunawardena and Zittle, 1997), and demographic questions. Subjects in the study were 128 students in an online RN-to-BSN program at one college in the northeastern United States who were taking an online nursing course during the study term. Results indicated that there was a strong relationship between overall satisfaction and overall social presence (rs = .63, p < .001)) and instructor performance (rs = .46, p < .001). Four sub-domains of social presence were identified: overall comfort with online and computer-mediated (CMC) communication, communication with CMC and the online environment, comfort and community of CMC/online environment, and attitudes toward CMC/online communication. Four sub-domains of satisfaction were identified: general satisfaction, usefulness of course, learning from course, and stimulation and ongoing learning. All sub-domains of social presence correlated highly (rs = .61 - .72, p < .001) with the satisfaction sub-domains except the communication factor which correlated to a lesser degree (rs = .39 - .45, p < .001). There was a strong relationship between perceived learning and social presence (rs = .61, p < .001) and with comfort with the online course (rs = .66, p < .001). Overall social presence, instructor performance, and the sub-domains of social presence predicted a significant amount (p < .001) of total variance in overall satisfaction and perceived learning. No significant relationships were found between the demographic factors and overall social presence or perceived learning. Females had significantly higher scores on the communication factor (p = .02) and subjects with more online course experience found the courses more useful (p = .04). / School of Nursing / Nursing / PhD / Dissertation

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