Compton College Nursing Program Self-Study Report

Accordingly, the Department of Consumer Affairs (DCA) waived the requirement of California Code ofRegulations, Title 16, sections 1426, subdivision (g) (2) and 1427, subdivision (a) to the extent they require aclinical setting to be approved by the Board of Registered Nursing, on the condition that a Nurse EducationConsultant must approve the clinical setting. One requirement was that at least 50% of clinical hours must be indirect patient care. The director submitted evidence to satisfy the BRN that the agency or facility being used isno longer available due to the conditions giving rise to the state of emergency, and no alternative agency orfacility located within 50 miles of the impacted nursing program, campus or location is available to theapproved nursing program by use by all of the impacted students for direct patient care clinical practice, andthat the substitute clinical practice hours not in direct patient care provide a learning experience that isreasonably comparable to the learning experience provided by the direct patient care clinical practice hours.A request was submitted for a minor curriculum change to waive the required 75% direct patient care hours dueto COVID-19 on April 14, 2020. The learning/training platforms offered support remotely for studentsincorporated vSim, case studies, docu-care, and other teaching modalities. The college campus closed with onlyremote instruction and provided faculty training with a learning management system, computers, and Wi-Fi hotspots to all students in need. The director followed up with faculty in their remote clinical time to ensure thatcourse objectives were met. The director also provided sufficient evidence satisfactory to the nurse educationconsultant to validate program conditions. The letter of approval for the minor curriculum change from theBRN was received on April 16, 2020.Many regional facilities continued to close for nursing students, presenting a problem with the completion ofdirect patient hours. A request for an extension of the minor curriculum revision for remote/online instructionthrough fall 2020 was submitted to the BRN. That request was approved on June 1, 2020 with the statement,“The college will be continuing remote/online instruction through Summer 2020 and possibly Fall 2020. Thisrequest for continuation will allow this instruction to continue for your nursing courses as approved by yourCollege Administrators.” The college provided laptops, Wi-Fi hot spots, housing referrals, and other resourcesto students during this time.Future Plans for the Program:Compton College is part of the Los Angeles Regional Nursing Curriculum Consortium (RNCC). The mission ofthe RNCC is to develop a common regional nursing curriculum that is integrated into a fully articulated ADNBSN concurrent enrollment pathway, decreasing units, and eliminating redundant content. The participatingADN programs will attain national accreditation. Once implemented, the curriculum will provide a streamlined,cost-effective pathway from ADN to BSN, serving the regional healthcare industry's needs and the diversestudents served. As industry seeks to hire RNs with bachelor’s degrees, our programs are seeking to reinventEDP-P-06 (Rev. 08/16)4.4.10

themselves to continue to meet the demand. The one-year process is underway and shows great progress ingrowing ADN programs and meeting the demand from industry for RNs with BSN degrees.EDP-P-06 (Rev. 08/16)4.4.11

Section 2: Total Program Evaluation [CCR 1424(b)(1)]Benchmarks:Attrition RateAcademic YearStudent Cohort Completion and Attrition201520162017Data201620172018Students Scheduled to Complete the Program 858688Completed on Time457542Still Enrolled2034Attrition2089Completed Rate *52.9%87.2%47.7%Attrition Rate23.5%9.3%10.2%*Completion rate (students who completed the program 020888611%97.7%1.1%Attrition Rate:A large number of nursing students never complete their nursing degree. Statistically, roughly one-quarter ofthe students graduate behind schedule, taking more than two years to complete, with an additional one-quarterof the students never graduating. One significant factor contributing to students dropping out of the nursingprogram is academic failure. Many of the students are not prepared academically for the rigor of the nursingcurriculum, resulting in substandard grades in their classes and eventually leaving the program. There are somestudents who have the necessary skills to be successful, but need to work full time to support themselves,making it difficult to devote sufficient time to their studies. Other contributing factors that hinder approximatelyone-third of the students successfully completing the program centers on personal reasons such as familyobligations and lack of support with child care.The nursing program strives to help students pass the National Council Licensure Examination-RegisteredNurse (NCLEX-RN) by implementing strategies to keep the rate above 75% or above. In 2013, the nursingprogram dedicated grant funds to support the hiring of faculty tutors and mentors to support the nursingdepartment’s Student Success Center. These individuals were assigned as faculty facilitators to support thetutoring and mentorship program, which was developed to assist students with additional content review andsurvival skills such as test-taking strategies. Students have the opportunity to schedule an appointment with afaculty mentor for assistance or attend open tutorial sessions offered strategically throughout the week. Theattrition rate in the nursing program is well below 25% and a topic of much concern and continuouslydiscussed. The data that would separate the generic and upward mobility students were not captured in theprevious academic years by the previous program director. Beginning fall 2020, this information will becaptured every semester.EDP-P-06 (Rev. 08/16)4.4.12

From the last self-study in 2015, it was noted that the first semester had a higher attrition rate compared to othersemesters, ranging from 8 to 16%. The higher rates may have indicated these students were sometimes not fullyaware about the culture of nursing or the demands of nursing school. Some of the students were in their secondor third careers, while some were working less than 20 hours per week and others are working over 20 hours perweek. Students revealed that they experienced financial difficulty, personal and/or family issues, and unrealisticexpectations of the nursing program workload.The upward mobility (LVN to RN) program offers licensed vocational nurses the opportunity to become aregistered nurse via the completion of the required prerequisites and nursing coursework. Although the abovedata not only represents the licensed vocational nurses seeking advanced standing in the nursing program, italso signifies individuals who are interested in transferring to the Compton College nursing program, andreturning students who have stopped or dropped out of the program for over a year.One area of concern regarding the faculty for the upward mobility student cohort group included individualsseeking admission into the track were licensed vocational nurses presenting limited to no experience. Theimplementation of the Multi-criteria Screening Process changed the admission criteria for the licensedvocational nurse entering the program. These individuals were required to have been licensed for a year, andhave worked for at least a year in an acute care setting.Due to the impact that the upward mobility student has on the nursing program, effective spring 2015, theAdmission, Transfer, and Progression Committee and the nursing counselor felt it was important to requirethese students to complete the same prerequisites as the generic nursing students. The group felt it wasimportant for these individuals to have recent direct patient care experience. As a result, there was a slightdecrease in the attrition; however, it was noted that this particular student cohort group continued to lack thebasic skills required to seek advance standing status in the nursing program.Action Plan:The faculty strives to keep the NCLEX-RN pass rate "above average." Therefore, funding for the StudentSuccess Facilitators through the use of the various grants to advise students who score less than 76% on anassignment, quiz or exam will continue. Additionally, referrals to different campus resources for students areused to assist students who need additional support with their academic endeavors, such as the Special ResourceCenter for students with disabilities, the Student Health Center, and the Financial Aid Office. Testingaccommodations, recommended by the Special Resource Center for students with disabilities, have also beenused by students successfully completing the nursing program. Once these students complete the program, theycan file for testing accommodations when taking the NCLEX-RN exam. Listed below are additional strategiesthat are implemented in the program to assist students toward academic success.EDP-P-06 (Rev. 08/16)4.4.13

The entire student body is encouraged to take advantage of all resources and tools available. The program willcontinue to provide an NCLEX review course or software for students who are completing the program,monitor student success on the NCLEX exam, make adjustments to the program curriculum or review thecourse and software to improve NCLEX results, and provide support staff to assist students.Effective with the spring 2016 application intake, the prerequisite requirements for the upward mobility studentwill mirror the requirements for the generic students. English will no longer count in the prerequisites 2.5 gradepoint average (GPA). The prerequisite GPA will be based on the three science classes: anatomy, physiology,and microbiology. Additionally, these students are required to be licensed as a vocational nurse for one year andhave worked in an acute care and sub-acute health care setting within the last three years.1. NCLEX Results: The program must achieve at least a 75% annual pass rate of first-time takers onNCLEX for the last two years.NCLEX Pass RateDuring the 2016-2017 academic year, NCLEX pass rates for graduates dropped below the mean pass rate scoresreported by the California BRN and the National Council of State Boards of Nursing (NCSBN). As a result, anaction plan to address this issue was that the RN ATI Capstone Proctored Comprehensive Assessment test andATI RN Comprehensive Predictor test were incorporated into fourth-semester curriculum. The RN ATICapstone Proctored Comprehensive Assessment test is administered at the start of the fourth semester andassessments are administered throughout the course. The ATI RN Comprehensive Predictor test is structured topredict the level of success for first-time test takers on the NCLEX. Another benefit of this test helps thestudents identify content areas that need more focused review in preparation for taking the NCLEX. Inaddition, learning resources and strategies for student success are re-evaluated and revised with student input.EDP-P-06 (Rev. 08/16)4.4.14

The nursing Student Success Facilitators highlight the use of critical thinking in the classroom, on exams, and inthe clinical setting. Workshops focusing on specific theory content or clinical skills are offered, andsupplemental remediation through ATI is utilized to augment students' knowledge of the nursing process. Theresults during the three academic years from 2017 to 2020 were highly successful: NCLEX-RN pass rates forour program exceeded mean pass rates at state and national levels (see the tables above).In April 2013, the NCSBN raised the passing standard for the NCLEX-RN from minus 0.16 logits to 0.00 logits(a logit being a unit of measurement that compares differences between estimated candidate ability and test itemdifficulty). Also, a higher number of questions having "select all that apply" answers were added to the NCLEXtest. Per the NCSBN website (https://www.ncsbn.org), pass rates tend to be lower with changes to the NCLEX.With the exception of the stated quarters with below the 75% mark, the Compton College action plan hasensured that students are being sufficiently prepared to pass the NCLEX-RN the first time. The program hasmaintained at least a 75% annual pass rate of first-time takers on NCLEX for the last two years.Effectiveness of the RN Comprehensive Predicator ExamStudents preparing to take the NCLEX-RN utilize the RN Comprehensive Predictor tests, (an ATI diagnostictest) to measure their readiness to test. As a result, the predictor probabilities become extremely important asstudents near the end of their curriculum. It is imperative for both the faculty and the students to know:1. How does a student's probability of a passing score from the predictor tests compare to their pass rate on theNCLEX?2. How many students are taking the RN comprehensive predictor and passing that year?3. Are the predictors accurately predicting student outcomes on the NCLEX?Compton College has variations in relation to the pass rate. For example, scores have plummeted to 50% in2019-2020 and were as high as 100% in 2018-2019 and 2019-2020. As faculty look closer at the pass rates, weEDP-P-06 (Rev. 08/16)4.4.15

can apply the questions presented above to gain insight into the effectiveness of the NCLEX predictor. Thereview identified the students who were low academically in the program, and who required additional tutoringand assistance. Using ATI Capstone as the tool for success during the last course, the program providedadditional support and allowed the student to become more familiar with NCLEX-style questions.The ATI practice and tutorial provide students with supplemental instruction, as well as enabling the students tobecome familiar with NCLEX-style questions. Moreover, students have the opportunity to review core contentand develop their critical thinking and application skills needed to master and pass the NCLEX.4. There must be a persistent, substantive pattern of student satisfaction with the program based onperiodic anonymous student surveys.Students are required to complete a clinical facility evaluation at the end of each clinical course. Also, eachfaculty evaluates the facility every semester. Some clinical facilities request the students complete their agencyspecific review, submitted to the hospital nursing office at the end of the clinical rotation.The results for Compton Center from the Total Evaluation Plan 2015-2019 indicate medication safety, lab dataand analysis, the nursing process, and the importance of a comprehensive nursing care plan should beemphasized, especially in the first semester for better understanding in these areas. Other areas found during thesurveys were: Continue utilizing critical thinking and test-taking strategies to improve test scores. Medications are essential in healthcare, with understanding the drug family, not one particular drugaction was more beneficial. Continuous reinforcement and the importance of APA formatting, especially for research in the programand when continuing to a four-year university, are required. Incorporate cultural sensitivity and communication in every course, especially in the clinical facilities.The academic year 2019-2020 has brought change to these areas. The new curriculum requires a 16-weekpharmacology course instead of two eight-week sessions. Concurrent learning for theory and clinic over acontinuum will allow students to build their knowledge base over time instead of a segmented course with twoinstructors. VSim is a resource the program has incorporated that allows the students to use critical thinkingwhile working through various simulated scenarios. The program can simulate care of different cultures toenable the student’s exposure to specific cultures and their diverse health care needs. DocuCare is anotherresource that has helped the student document patient care using the nursing process, critical care, andunderstanding the importance of lab values and communication.EDP-P-06 (Rev. 08/16)4.4.16

To increase the number of respondents, the Evaluation Committee attended each class throughout the semesterto administer the survey via PowerPoint and clicker-response. The result was much improved and of quality tomake decisions for the program.The tool used to collect data had software issues during spring 2019 and fall 2019, posing a problem withoutcome data. The Evaluation Committee and the college’s Office of Institutional Effectiveness workedtogether to place all surveys electronically. In spring 2020, students were sent an email at the end of thesemester, which contained a link to capture the necessary data. The survey for spring 2020 was emailed after thecourse ended, but too late to capture qualitative data.Overall, the evaluations of the Code 3 - clinical facilities completed by students were favorable. Approximately90% of the surveys received showed students agreed with Code 3 statements involving adequate patient/clientcensus with various health problems, receptive learning environment, staff support, and sufficient resources.Code 3 resulted in 79 students from all courses completing the survey. All responses to the

The program was previously under the El Camino College Nursing Program's operation from June 2005 until June 7, 2019. During that time, there were several directors and interim directors of the El Camino College Compton Community Educational Center's nursing program until a permanent director was appointed. Dr.