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OBJECTIVE: To evaluate the cost-effectiveness of clinical education models for undergraduate nursing programs. METHODS: A model-based cost-effectiveness analysis. Settings were universities with undergraduate nursing courses. Participants consisted of the decision tree that guided the structure of the model, filled in with effectiveness results from a hypothetical cohort of undergraduate nursing students. Interventions were Clinical Preceptor or Clinical Facilitator or Clinical Education Unit. Main outcome measure was effectiveness, defined as improvement of clinical education. The projected economic outcomes included incremental costs, incremental effectiveness, and incremental cost-effectiveness ratio. Monte Carlo probabilistic sensitivity analysis was employed to assess uncertainty in the model and robustness of our results. RESULTS: The model based on Clinical Education Unit could be defined as the best, followed by Clinical Facilitator and Clinical Preceptor. The incremental cost of telephone-support intervention was US$ 59,604.40 higher than the second-best performing intervention (Clinical Facilitator), and US$ 32,661.86 higher than the last best performing intervention (Clinical Preceptor). In addition, Clinical Education Unit model showed 7% and 19% more effectiveness than Clinical Facilitator and Clinical Preceptor, respectively. CONCLUSION: Clinical Education Unit represents the best choice to promote better development of skills, knowledge and socialization in undergraduate nursing programs considering its effectiveness and costs.

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ABSTRACT Objective To evaluate the cost-effectiveness of clinical education models for undergraduate nursing programs. Methods A model-based cost-effectiveness analysis. Settings were universities with undergraduate nursing courses. Participants consisted of the decision tree that guided the structure of the model, filled in with effectiveness results from a hypothetical cohort of undergraduate nursing students. Interventions were Clinical Preceptor or Clinical Facilitator or Clinical Education Unit. Main outcome measure was effectiveness, defined as improvement of clinical education. The projected economic outcomes included incremental costs, incremental effectiveness, and incremental cost-effectiveness ratio. Monte Carlo probabilistic sensitivity analysis was employed to assess uncertainty in the model and robustness of our results. Results The model based on Clinical Education Unit could be defined as the best, followed by Clinical Facilitator and Clinical Preceptor. The incremental cost of telephone-support intervention was US$ 59,604.40 higher than the second-best performing intervention (Clinical Facilitator), and US$ 32,661.86 higher than the last best performing intervention (Clinical Preceptor). In addition, Clinical Education Unit model showed 7% and 19% more effectiveness than Clinical Facilitator and Clinical Preceptor, respectively. Conclusion Clinical Education Unit represents the best choice to promote better development of skills, knowledge and socialization in undergraduate nursing programs considering its effectiveness and costs.

RESUMO Objetivo Avaliar a relação de custo-efetividade dos modelos de educação clínica para cursos de graduação em enfermagem. Métodos Análise de custo-efetividade baseada em modelo. Os ambientes foram universidades com cursos de graduação em enfermagem. Os participantes consistiram na árvore de decisão, que norteou a estrutura do modelo, preenchida com resultados de efetividade de uma coorte hipotética de estudantes de graduação em enfermagem. As intervenções foram o Preceptor Clínico ou o Facilitador Clínico ou a Unidade de Educação Clínica. A principal medida de resultado foi a efetividade, definida como a melhoria da educação clínica. Os resultados econômicos projetados incluíram custos incrementais, efetividade incremental e custo incremental por efetividade. A análise probabilística de sensibilidade de Monte Carlo foi utilizada para avaliar a incerteza no modelo e a robustez de nossos resultados. Resultados O modelo baseado na Unidade de Educação Clínica foi o melhor, seguido pelo Facilitador Clínico e pelo Preceptor Clínico. O custo incremental da intervenção com suporte por telefone foi US$ 59,604.40 a mais do que o da segunda intervenção de melhor desempenho (Facilitador Clínico) e US$ 32,661.86 a mais do que a última intervenção de melhor desempenho (clínico preceptor). Além disso, o modelo da Unidade de Educação Clínica mostrou 7% e 19% mais efetividade do que Facilitador Clínico e Preceptor Clínico, respectivamente. Conclusão A Unidade de Educação Clínica representa a melhor escolha para promover um desenvolvimento de habilidades otimizado, conhecimentos e socialização nos cursos de graduação em enfermagem, considerando efetividade e custos.

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Supporting nurses with associate degrees in nursing (ADNs) to return to school is challenging for nurse executives. Strategies include tuition reimbursement, scholarships, and flexible scheduling. Despite these measures, it is anticipated that we will fall short of a goal of 80% bachelor's degree-prepared nurses by 2020. The aim of this project was to increase ADN-prepared RN readiness to return to school through motivational interviewing.

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Financial support for students entering nurse education programmes has typically been the responsibility of Governments who make a substantial contribution to tuition and/or living costs. However, where programmes are not funded by Government bodies, students must make alternative arrangements for financial support. This paper explores how a university worked with local employers to design, recruit and deliver an accelerated graduate entry nursing programme and how this philosophy of collaboration ultimately led to local health employers providing sponsorship for students. Therefore, we offer for debate the benefits of collaborative curriculum design and future considerations of attracting employer funding for graduate entry nursing programmes.

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In their 2011 report, The Future of Nursing, the Institute of Medicine called for 80% of the nursing workforce to be comprised of baccalaureate prepared Registered Nurses by the year 2020. One suggested approach to achieve this goal is the creation of programs that allow students to progress through associate and baccalaureate nursing preparation simultaneously. This paper describes the University of Central Florida's 13-year experience after implementing a Concurrent Enrollment Program. Development and structure of the program, advisement and curriculum details, facilitators and barriers are described. Data on National Council Licensure Examination for Registered Nurses pass rates, completion rates, comparison with traditional RN-BSN students, and progression to graduate school are also included. The Concurrent Program model described here between a specific university and state college partners, demonstrated positive outcomes that support achievement of the Institute of Medicine's goals.

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Over 670,000 ADN- and diploma-prepared nurses will need to complete their BSN degrees to meet the Institute of Medicine's recommendation that at least 80% of registered nurses (RNs) be BSN-prepared by year 2020. Understanding motivators, barriers, and the transition experience for RNs to advance their degree will help educators and nurse leaders understand the importance of a partnership to educate and mentor RNs to pursue a BSN degree.

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PROBLEM: Significant off-campus domestic study away experiences have been shown to be a transformative active learning environment for students and achieve similar learning outcomes as study abroad programs. METHODS: This manuscript describes the conception, development, and pedagogical approach of a faculty-led domestic study away experience in New York City for pre-licensure and post-licensure nursing students as an active learning strategy for developing cultural competence. Students participated in service-learning activities that illuminated the realities and challenges persons from other cultures face as they interact with health care in a culture that is not their own. FINDINGS: In partnership with New York Cares©, students were immersed in well-established ongoing sustainable community-based projects. These experiences fostered reflective conversations between community members, student participants, and faculty regarding social factors, cultural issues and needs, and global issues and trends. CONCLUSIONS: Through the New York study away program, students were able to broaden their perspectives about social factors and culture beyond geographic or ethnic boundaries and apply these service experiences to their nursing practice. Study away programs are an excellent strategy for nursing educators to prepare students for care of multicultural populations and for proficiency in cultural competency within the globalization of the United States.

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BACKGROUND: The nursing profession forms the backbone of many healthcare systems. It therefore needs a consistent supply of registered nurses to deliver continuous and safe quality healthcare, and to replace the nurses leaving or retiring from the profession. Attrition actively occurs among nursing students in South Africa and threatens the future supply of registered nurses. AIM: The aim of the study was to describe the attrition rate at selected South African universities and the factors influencing undergraduate nursing students to discontinue their nursing studies at these universities. METHOD: A quantitative descriptive design was followed. Heads of the nursing departments at the selected universities captured data with a specifically designed questionnaire. Thereafter their former nursing students provided information via a structured telephonic interview on the reasons why they discontinued the nursing programme. RESULTS: The study revealed that attrition of undergraduate nursing students for three intake years (2007, 2008 and 2009) at the participating universities was between 39.3% and 58.7%. Academic and financial reasons as well as poor wellness and health were the main causes for attrition. Another factor was failure to cope with the demands of the clinical environment. CONCLUSION: Attrition might not occur immediately when a nursing student is challenged, as the student might exploit the various types of support offered. Although some nursing students do benefit from the offered support, a large number of nursing students still discontinue the undergraduate nursing programme.

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I'm a nursing student and have just worked 85 hours in the last 8 days. I've had 1 day off in that period of time. I've not seen my daughter in days and I can't get a paid part time job as, let's face it, I have to actually sleep.'

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Millions of pounds have been paid to debt-ridden nursing students to prevent them from dropping out of university courses. Data exclusively obtained by Nursing Standard shows £5.2 million in discretionary funding has been handed out since 2013.

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BACKGROUND: Nursing education appropriate to the learning needs of Aboriginal and Torres Strait Islander students is essential to prepare them for registration as nurses. Despite incentives to encourage the recruitment and retention of such students, a disproportionate number commence but do not finish their nursing studies. OBJECTIVES: To describe the barriers and enablers to the retention of Aboriginal students in a Diploma of Nursing course (Enrolled/Division 2) in Western Australia. DESIGN: An exploratory descriptive design was used. SETTINGS: One metropolitan educational facility catering for Aboriginal people offering an 18-month course in a block release format. PARTICIPANTS: A convenience sample of 16 students aged 18+years. METHODS: Newly enrolled students (n=10) participated in an investigator-developed survey to explore their motivation for entering the course. Nine of these students and a further seven students who were nearing the end of their course participated in focus groups to explore their experiences of nursing education. RESULTS: Survey respondents had a mean age of 32.7years; most were female, had nominated family as influential in the decision to enroll, and commenced with a friend. Regarding recruitment and retention, the qualitative data highlighted the importance of students': perceptions of the training organisation, characteristics, experiences of nursing education, and sources of support. CONCLUSIONS: Strategies that develop individual's resilience and engage supportive networks can assist Aboriginal students to negotiate tertiary nursing study. Academic skills assessments supplemented with tailored educational support at entry can resource students to navigate increasingly complex course content. Flexibility throughout the course enables students to negotiate study in a context of ongoing family and financial obligations.

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UNLABELLED: The international nursing shortage has increased recruitment of students, who may be under or unprepared, into higher education institutions (college or university). BACKGROUND: The global economic downturn and the movement toward standardizing nursing education and practice regulations has encouraged higher education to recruit and retain aspiring nursing students. However, deficiencies in mathematics and English have been linked to disappointing results with economic consequences. PURPOSE: The objective of this study was to describe the incidence and monetary costs associated with remediation, course repetitions, delay to graduation, and first time passage on the American licensing exam National Council Licensure Examination for Registered Nurses. METHODOLOGY: A convenience sample of 103 sophomore nursing students from a college in the northeast United States was followed to graduation. The sample was predominately female, single, age 18-25 years, and White. FINDINGS: Mathematics and English remediation courses taken were 123. There were 148 course repetitions with 104 in the biological sciences and 44 in nursing. Direct relationships were found between the number of overall remedial courses and course repeats (r = .40, p = <.001, CI = 95%) with a strong negative correlation with the number of course repetitions (r = -.60, p = <.001, CI = 95%) and on-time graduation. Sixty-two students (60%) of the original cohort graduated and took the registered nurse licensing examination with 56 passing. In this American study, the direct and indirect cost of remediation, course repetition and lost income opportunity was greater than $1.6 million. CONCLUSION: Interdisciplinary collaboration, including nursing faculty, is critical in the recruitment and retention of nursing students. Without structured pre-admission evaluation the short and long term financial and academic effects of under or unprepared students is disquieting.

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This column, presented by the American Organization of Nurse Executives, discusses the results of the initial 9 state-funded coalition grants to increase the levels of education among RNs and smooth academic transition.

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