TWU
Doctor
of
Nursing
Practice
Program
Translating
Research
into
Practice
Proposal:
Distance
Education
Program
for
the
Post
‐
Master’s
Doctor
of
Nursing
Practice
Texas
Woman’s
University
College
of
Nursing
Texas
Higher
Education
Coordinating
Board
Distance
Education
Doctoral
Degree
Proposal
Directions: An institution shall use this form to propose a new doctoral degree program. In completing the form, the institution
should refer to Texas Administrative Code (TAC) 5.46 relating to Criteria for New Doctoral Programs. This form requires signatures of
(1) the Chief Executive Officer, certifying adequacy of funding for the new program; (2) a member of the Board of Regents (or
designee), certifying Board approval; and (3) if applicable, a member of the Board of regents or (designee), certifying that criteria have
been met for Coordinating Board staff‐level approval.
Note: If an institution does not have Preliminary Authority for the proposed doctoral program, it must first submit a separate request
for Preliminary Authority. That request shall address criteria set in TAC Section 5.24 (b).
Information: Contact the Division of Academic Affairs and Research at 512/427‐6200.
Administrative Information
1. Institution: Texas Woman’s University
2. Program Name: Doctor of Nursing Practice (DNP)
3. Proposed CIP Code: 51.3818.00
4. Program Description:
Texas Woman’s University (TWU) seeks to offer its Doctor of Nursing Practice (DNP) program through
hybrid delivery. Accredited by the Commission for College Nursing Education, the Doctor of Nursing
Practice program prepares post‐master’s Advanced Practice Registered Nurses (APRNs) to function as
expert clinicians in primary and acute care. DNP students acquire a strong repertoire of technological
competencies that will enable them to fill expanded roles as clinical experts who provide and integrate
evidence‐based care and incorporate research into practice. The DNP program expands upon the
knowledge base and skill set of the master’s‐prepared Advanced Practice Registered Nurse and broadens
this knowledge base to include informatics, genetics, health care administration, and expanded clinical
expertise. The DNP graduate is prepared as an interdisciplinary leader able to conduct and evaluate
evidence‐based outcomes research and to develop policy and advance system change.
The proposed hybrid DNP program will replace the existing DNP program. Using hybrid methods, face‐to‐
face class sessions will focus on application and interaction; online coursework will focus on content
acquisition and analysis. The content of the curriculum and progression through the curriculum will be
unchanged. A hybrid delivery format will permit TWU to: (a) serve APRNs who practice in rural areas of
Texas, (b) facilitate DNP education for nurse practitioner graduates of Texas colleges that do not offer
doctoral programs, (c) create opportunities for TWU nursing faculty to form research collaborations with
healthcare providers and APRNs throughout Texas, and (d) increase the numbers of clinically expert
nursing faculty with doctoral preparation, thus helping to alleviate the severe nursing faculty shortage in
Texas Woman’s University has graduated two classes of DNP students. Since the first class entered the
program in June 2008, faculty members have been able to create and refine DNP coursework. During this
period DNP faculty members implemented a range of distance education modalities (e.g., virtual
classrooms, digital video, and Internet conferencing) to augment face‐to‐face classroom experiences.
Support from the TWU Office of Distance Education will provide opportunities to further enhance these
distance education skills.
5. Administrative Unit: College of Nursing
6. Proposed Implementation Date: Summer 2012
7. Contact Person: Provide contact information for the person who can answer specific questions about the
program.
Name: Dr. Lynda Murphy
Title: Director of Distance Education
E‐mail: lmurphy@twu.edu Phone: 940‐898‐3405
Table of Contents
I. Summary of Request ... 1
A. Degree Program Area ... 1
B. Degree Title Designation ... 1
C. Program Delivery ... 1
D. Program Site ... 2
II. Reason for Request ... 2
A. Program Need ... 2
B. Program Demand—Job Market and Student Interest ... 2
C. Program’s Role ... 5
III. Program Description ... 6
A. Program Construction ... 6
B. Administrative Oversight ... 10
C. Administrative Structure ... 14
IV. Relationship to Existing Authorized Doctoral Programs ... 14
A. Relationship Between Proposed Distance Education Program and Existing On‐Campus Program ... 14
B. Student Interaction ... 14
V. Expected Enrollment ... 16
A. Anticipated Head Count ... 16
B. Impact on Existing Face‐to‐Face Program ... 17
C. Student Projections ... 17
VI. Faculty Resources ... 18
A. Faculty Resources ... 18
B. Equipment, Software, Connectivity Needs ... 20
C. Facilities, Equipment, and Library ... 20
VII. Financial Support ... 22
A. Anticipated Costs ... 22
B. Budget ... 22
C. Financial Support ... 24
VIII. Additional Distance Delivery Considerations ... 24
A. Adherence to the Principles of Good Practice ... 24
B. Delivery Modes ... 24
D. Program Differences ... 25 E. Student Interactions ... 26 IX. Evaluation ... 28 A. Program Quality ... 28 B. Participant Satisfaction ... 29 C. Assessment Procedures ... 29 D. Use of Assessment ... 30 References ... 32 Appendices ... 33
Appendix A: TWU, College of Nursing, and DNP Mission and Goals Congruency ... 33
Appendix B: DNP Curriculum ... 38
Appendix C: Matrix of DNP Courses, Objectives, and Content Correspondence With AACN Essentials ... 43
Appendix D: Doctor of Nursing Practice Faculty: Credentials, Specialization, Courses, Role ... 58
Appendix E: Anticipated Sources of Funding ... 61
Appendix F: Costs to the Institution of the Program/Administrative Change ... 64
Appendix G: Adherence to the Principles of Good Practice ... 66
Distance Doctoral Degree – Program Request
I. Summary of Request
A. Degree Program Area
Doctor of Nursing Practice (Nursing)
B. Degree Title Designation (e.g., PhD, EdD, etc.)
DNP
C. Program Delivery
The TWU Doctor of Nursing Practice (DNP) was designed for post‐master’s Advanced Practice Registered Nurses (APRNs) and has been offered as a face‐to‐face program since 2008. The proposed hybrid program will build upon a strong pedagogy of face‐ to‐face delivery and distance education technologies to deliver content and enhance interactions. Blackboard Learn will be the primary delivery system for this proposed program, and other technologies will be employed as necessary to deliver high quality materials to students (e.g., digital video, Internet conferencing, and virtual classrooms). The proposed hybrid DNP program will completely replace the on‐ campus program by the Summer 2012 semester. The current curriculum and course progression will remain unchanged; only the delivery method will be altered.
The first cohort of students entered the TWU DNP doctoral program in June 2008. DNP faculty members have been committed to ongoing performance improvement through creation and refinement of the DNP curriculum and coursework. Faculty have also implemented a range of distance education modalities within the current program (e.g., virtual classrooms, digital video, and Internet conferencing) for the following purposes: (a) to enrich and augment face‐to‐face classroom experiences, (b) to better accommodate the large proportion of DNP students who must travel great distances to attend DNP classes, and (c) to facilitate learning for the many DNP students who are not native English speakers. Support from the TWU Office of Distance Education will provide opportunities to further enhance these distance education skills and allow for seamless integration and smooth transition into hybrid delivery of the current curriculum. As in the current face‐to‐face program, DNP students may choose to pursue full‐time or part‐time study to complete the 46‐ credit‐hour program.
D. Program Site
The program will be administered through the College of Nursing, which has classrooms and office spaces on all three of TWU’s campuses—Denton, Dallas, and Houston. As in the current program, DNP students may choose from a menu of online electives that are offered from all campus locations. Many of these electives are courses available from the PhD in Nursing Science program offered from the Denton and Houston campus sites. The PhD in Nursing Science has been delivered as an online program since 2000.
II. Reason for Request
A. Program Need
No other hybrid DNP programs are offered by a Texas public university. Texas Christian University, a private university in Fort Worth, Texas, offers an online DNP program. Offering a hybrid option will provide opportunities for more Texas nurses to obtain a DNP education.
B. Program Demand—Job Market and Student Interest
The proposed change in the mode of delivery of the post‐master’s DNP program curriculum from face‐to‐face methodology to hybrid methodology is consistent with national and state initiatives delineating the future of nursing education and
practice. In the 2010 Institute of Medicine (IOM) report to the nation, The Future of Nursing: Leading Change, Advancing Health, the IOM and the Robert Wood Johnson Foundation recommended that: (a) nurses should achieve higher levels of education and training through an improved education system that promotes seamless
academic progression and (b) universities should endeavor to double the numbers of nurses with doctorates by 2020. The post‐masters, hybrid DNP educational option would increase the numbers of APRNs with doctoral preparation who could serve as faculty members, thus helping to alleviate the nursing shortage in Texas.
The post‐master’s hybrid DNP program would also enable TWU to serve APRNs who practice in rural areas of Texas. The percentage of practitioners who live and
practice in distant areas is increasing with each TWU DNP cohort. Approximately 29% of the students in the first DNP class traveled over 200 miles to attend TWU. Among students who will graduate this year, 44% travel over 200 miles to attend TWU. Of the students projected to graduate in 2012, 66% travel over 200 miles to attend TWU. The economic burden and time spent in travel throughout the semester can create insurmountable barriers to higher education.
The increasing average lifespan and an expanding, aging, and diverse Texas population are driving the demand for health care services. There will be fewer nurses, however, to care for the increasing numbers of Texans; and a greater proportion of these Texas citizens will represent underserved populations. The production of DNP graduates is one excellent way to cope with the pending nursing shortage and increasing complexity of providing health care to Texas residents.
Transitioning the existing TWU DNP program to a hybrid model would:
Increase the supply of faculty for clinical and didactic instruction in nursing. Increase numbers of APRNs with advanced practice nursing competencies who
can provide care for rural and urban underserved populations in complex clinical arenas.
Create leaders able to deliver healthcare via inter‐professional teams. Provide parity with other health care professionals, most of whom have a
doctorate as the credential required for practice.
The TWU DNP student population currently includes representatives from the following licensed Advanced Practice Registered Nurses: (a) Certified Nurse Midwives, (b) Family Nurse Practitioners, (c) Adult Nurse Practitioners, (c) Acute Care Nurse Practitioners, (d) Pediatric Nurse Practitioners, (e) Neonatal Nurse Practitioners, (f) Psychiatric‐Mental Health Nurse Practitioners, (g) Women’s Health Nurse Practitioners, and (h) Geriatric Nurse Practitioners. During 2010 and 2011, TWU DNP students provided care to 13,698 patients (See Table 1). Urban
underserved locations were sites for 4,452 clinical encounters, and rural
underserved locations were sites for 2,489 clinical encounters. Approximately 50% of all DNP student encounters were with the medically underserved. The proposed hybrid program will foster and support increased opportunities for this diverse population of DNP students to better serve vulnerable populations throughout Texas.
Table 1
Recipients of DNP Student Care 2010‐2011
Patient Group Clinical
Encounters Patients with Medicaid 4,021 Patients with Medicare 1,633 Patients with no insurance 3,073 Hispanics African Americans 4,697 Native Americans 196 Asians 210
Job market. To assess employment requirements for Advanced Practice Registered Nurses, TWU College of Nursing (CON) faculty members surveyed jobs that were posted on the Texas Nurse Practitioners website during a 7‐month period. Of the 54 jobs for nurse practitioners that were posted, 34 employers indicated the need for additional expertise in the following areas: (a) specific critical care expertise (pulmonary, cardiac, neurology, or trauma) in primary and acute‐care settings; (b) ability to function in both acute‐care and primary care settings; (c) capacity to evaluate and treat a variety of complex patient populations; (d) expertise in marketing, management, and business; (e) ability to use and interpret advanced diagnostic strategies; (f) proficiency with new technological innovations for diagnosis and management of patient care (e.g., electronic health records); and (g) expertise in specialty areas (oncology, infectious disease, pain management, sleep disorders, cardiology, psychiatric disorders, addiction, and obesity).
DNP graduates can also help to alleviate the nursing faculty shortage in Texas. The Texas Center for Nursing Workforce Studies noted in a report to the 79th Texas State Legislature that Texas will need the number of new graduates in nursing to increase to 18,000 in 2015 and 25,000 in 2020. There were 9,096 graduates from initial Registered Nurse licensure programs in 2010 in Texas. Fifty‐eight nursing
educational programs in Texas reported that lack of faculty was the most significant barrier to educating more Registered Nurses. Regarding Advanced Practice
Registered Nurses, 29% of qualified applicants were denied admission to Texas schools because of lack of budgeted faculty positions and lack of qualified faculty applicants. In 2010, 8.7% of budgeted Advanced Practice Registered Nursing faculty positions were vacant, with an average time of 30 weeks needed to fill the position (Texas Center for Nursing Workforce Studies, 2010). The hybrid delivery of the DNP program will enable competent Advanced Practice Registered Nurses to acquire education needed to function as advanced practice nursing faculty, while maintaining competency in clinical practice.
Potential student interest. The TWU DNP Task Force conducted an online survey of nurse practitioners in April 2005. The most common reason cited for motivation to pursue DNP education was to better prepare nurse practitioners to provide care to complex, co‐morbid patients in a rapidly changing health care system. Participants suggested that DNP programs should provide online support for coursework. A survey of 189 Advanced Practice Registered Nurses in North Texas and beyond conducted at the American Academy of Nurse Practitioners national conference in 2006 indicated:
Approximately 75% of the respondents were interested in pursuing a DNP degree.
85% wanted the DNP to focus on increased clinical expertise, 8% preferred an educational focus, and 2% desired an administrative focus.
The most important concern was to provide a curriculum that would allow these providers to work and study.
In September 2011, DNP faculty surveyed Texas nurse practitioners who attended the Texas Nurse Practitioner Conference in Fort Worth. Forty‐seven conference attendees volunteered to complete the survey. Results of the survey indicated:
Approximately 83% of the respondents wanted to pursue the post‐master’s DNP, and 4.3% were interested in the PhD in Nursing Science.
85.1% of the nurse practitioners were employed as full‐time health care providers, and 10.6% of the nurse practitioners were employed as part‐time health care providers.
Most of these nurse practitioners (76.6%) worked week days, with 19.1% working a combination of weekdays and weekend days.
Saturday was designated as the “best day” to attend class by 74.5% of the respondents. Other choices were alternate Saturday classes (27.7%) or monthly Saturday classes (23.4%).
40.4% of the respondents said they could start the DNP program in 2012. 19.1% said they could begin DNP education in 2013, with 29.8% of the respondents wanting to begin DNP education after 2013.
C. Program’s Role
As a state‐supported institution, TWU has a responsibility to meet the higher education needs of the citizens of Texas. Within the College of Nursing, this responsibility is expanded to include the health care needs of the residents of this state and this nation. This proposal affirms the College of Nursing’s commitment to produce critically needed Advanced Practice Registered Nurses with doctoral preparation and to meet the state’s Closing the Gaps initiatives for increasing the number of graduates in health programs. DNP graduates serve as clinically‐skilled faculty members for undergraduate and graduate nursing students and provide expert primary and acute care to underserved populations in rural and urban Texas. With a long tradition of successful delivery of distance courses and degrees, TWU would continue to increase access to specific distance education degree programs for working health professionals. The close correspondence among mission and goal statements of Texas Woman’s University, the College of Nursing, and the proposed Doctor of Nursing Practice hybrid program is a strength. Appendix A illustrates the congruence of these relationships among university, college, and program goals.
III. Program Description
A. Program Construction
This section of the proposal presents a comprehensive overview of the proposed hybrid DNP program. The following primary elements of program construction and implementation are reviewed:
Summary of DNP Program
Mission, Goals, and Expected Student Outcomes
Curricular Objectives, Program Objectives, Course Objectives, and Module Objectives
Application and Admission Processes
Degree Requirements and Expectations of DNP Students Curriculum Content and Progression
Summary of DNP program. The TWU DNP program is a post‐master’s program for APRNs that consists of 46 credit hours, with full‐time DNP students completing on average 6 to 9 semester hours for 6 semesters. The total full‐time program length is 2 years. Part‐time students generally are able to complete the program in 9
semesters or 3 years. Curriculum requirements for the proposed hybrid DNP
program are the same as the current face‐to‐face DNP program, with DNP graduates completing 90 credit hours after the baccalaureate degree.
Mission, goals, and expected student outcomes. The proposed hybrid program only strengthens current program mission, goals and student learning outcomes. Indeed access to coursework via hybrid methods reduces non‐productive time spent in commuting and increases time available for attention to study and achievement of learning outcomes. Table 2 illustrates the congruence among the DNP mission statement, hybrid DNP program goals, and expected student outcomes.
Table 2
DNP Mission, Student Program Goals, and Expected Student Outcomes
DNP Mission Hybrid DNP Program Goals Student Goals The TWU Doctor of
Nursing Practice is
designed to prepare
APRNs to function as
expert clinicians who
integrate and evaluate
evidenced‐based
practices in acute and
primary care settings.
The DNP curriculum
broadens and expands
upon the skills of the
master's prepared APRN
to include: enhanced
clinical expertise;
implementation of
healthcare informatics
technologies; and
increased depth in the
application of scientific
advances and health
care organizational
concepts to nursing
practice.
The goals for the hybrid DNP program are to:
1. Create and implement a post‐
master’s hybrid Doctor of Nursing
Practice Program that will
produce clinical nurse experts
uniquely qualified to deliver care
to all populations, including rural
and underserved populations,
through: (a) intense clinical
training in the provision of
culturally competent care; (b)
translation of evidence‐based
science into practice; (c)
incorporation of the sequence‐
based, genomic paradigm into
evidence‐based care; and (d)
implementation of technological
innovations, information science,
and evaluation of practice
outcomes.
2. Build and retain a diverse,
qualified DNP student body of
Advanced Practice Registered
Nurses who represent expert
APRN clinical practice.
3. Produce a cohort of DNP nurse
leaders who will receive the
training and skills to lead and
function effectively within inter‐
professional teams; create
innovative, collaborative
corporate/community/agency
partnerships; shape health care
policy leading to culturally
competent care and the
eradication of current healthcare
disparities; and function as
clinically expert nursing faculty.
The TWU hybrid DNP program will prepare expert APRNs who will:
1. Apply evidence from nursing and the
biophysical, psychosocial, behavioral,
and clinical sciences to complex
health issues.
2. Synthesize concepts of health
promotion, genetics, and disease
prevention in managing complex
health problems.
3. Implement health care delivery
models and informatics strategies
designed for quality improvement in
patient care.
4. Implement health care delivery
models and informatics strategies
designed for quality improvement in
patient care.
5. Analyze existing research and design
and conduct evaluations of clinical
interventions to implement evidence‐
based practice.
6. Employ an evidence‐based
framework when conducting
research on clinical interventions.
7. Develop and advocate for health care
policy.
8. Collaborate with other health
professionals to provide high quality,
ethical patient‐centered care that
meets current standards of best
practice.
9. Apply expert clinical judgment in
providing comprehensive
assessment, diagnosis, and
management of health and illness in
diverse populations.
10. Provide visionary nursing leadership
through contributions to the
management and guidance of health
care systems.
Application and admission process. All DNP applicants must meet the general requirements for admission to the TWU Graduate School. DNP applicants must also submit Graduate Record Examination (GRE) or Miller Analogies Test (MAT) scores with the completed ApplyTexas online application.
In addition to these general requirements, the College of Nursing requires the following academic requirements for unconditional admission to the Doctor of Nursing Practice program: (a) master's degree with a major in nursing from a
program accredited by a nationally recognized accrediting body, (b) a minimum grade point average (GPA) of 3.5 on prior graduate level course work or a preferred score of 460 on the Graduate Record Examination (GRE) Verbal and 500 on the GRE Quantitative or a preferred score of 50 on the Miller Analogies Test (MAT) for tests taken prior to October 2004 or a preferred score of 400 on the MAT for tests taken after October 1, 2004, (c) a course in nursing research at the graduate level, and (d) a course in statistics at the graduate level. Professional requirements for admission include: (a) current unencumbered license to practice professional nursing in the United States, (b) certification as an Advanced Practice Registered Nurse from a nationally recognized nursing certification body that is accredited by the appropriate national standard organization, and (c) eligibility to be recognized as an Advanced Practice Registered Nurse in Texas with an unencumbered license maintained throughout the DNP program. In addition, the DNP applicant must submit a curriculum vita or resume, two letters of recommendation from professional associates, and an essay discussing personal professional goals.
Applicants who do not meet the unconditional criteria, but who have a minimum GPA of 3.0 on prior graduate coursework, may be considered for provisional admission on an individual basis. Factors that will be considered in the admission decision include the grade point average on graduate‐level work, GRE Verbal and Quantitative scores or MAT score, scholarly activities, professional leadership, and work history.
The master’s degree completed by the DNP applicant must include foundation courses in nursing theory, nursing research, advanced health/physical assessment, advanced physiology and pathophysiology, and advanced pharmacology. If
comparable courses have not been part of the master’s degree program, they may be completed as provisions for entering the DNP Program. Prerequisite clinical courses focused on the advanced practice specialty must be sufficient for the applicant to be certified in that specialty by a nationally recognized certification organization. Prior to enrollment in the clinical practicum courses of the DNP, the student must have completed at least 1 year of full‐time experience as an APRN. DNP students are required to complete drug testing and criminal background screening.
Degree requirements and expectations of DNP students. The DNP degree plan
requires a minimum of 90 semester credit hours beyond the baccalaureate degree. The credit hours on the degree plan include both master’s‐level courses and the prescribed doctoral course work as identified below. Fifty percent (50%) of the total courses on the degree plan must be completed at TWU. There is no time limit on courses completed as part of a master’s degree. All additional course work on the degree plan must be completed within 10 years.
In addition to published degree requirements, DNP students craft a digital portfolio consisting of highlights of DNP coursework, digital video of class and capstone presentations, a 5‐year post‐graduation career plan, and articles submitted for publication. Degree plan requirements and student expectations will not change in the proposed hybrid delivery program
Curriculum content and progression. The DNP program is a post‐master’s program
built on the foundation of the advanced practice nursing master’s curriculum, producing graduates well able to lead and organize care delivered to large, complex patient populations. Students expand competencies obtained during their master’s education and clinical practice through courses in genetics, epidemiology,
informatics, health policy, and health systems management. The DNP student, therefore, enters the DNP program with between 44 to 50 credit hours obtained through master’s education, which includes courses in nursing theory, nursing research, advanced assessment, pharmacology, differential diagnoses, graduate statistics, advanced practice nursing role, and differential diagnoses of specific patient populations. Each DNP student then articulates through an additional 40 hours of DNP course work. During the first year of full‐time articulation, DNP students take courses in philosophy, management, information sciences, genetics, ethics, epidemiology, health care policy, informatics, and measurement. The DNP program receives strong support from other colleges and schools within the University during the first academic year, which is a particular strength of the TWU DNP curriculum. These courses provide the foundation for the second year of coursework, which consists of two clinical practicum experiences and the DNP capstone project. DNP students also choose 6 hours of electives from courses designed to provide specified content in individual areas of interest. Appendix B includes tables that illustrate TWU DNP curricular credit‐hour categories,
designation of course delivery through hybrid delivery or online delivery, part‐time and full‐time DNP curriculum plans, and a menu of DNP hybrid or online electives. Appendix C presents DNP course descriptions as they relate to the American
Association of Colleges of Nursing document, The Essentials of Nursing Education for Advanced Nursing Practice (2006), which reflects the national consensus regarding DNP curriculum content and forms the basis for DNP accreditation by the
Commission for Collegiate Nursing Education (CCNE). The TWU DNP program received initial accreditation from CCNE in 2010, with no recommendations for improvement.
Professional Capstone Project. The established professional capstone process requires the DNP student to complete a clinical inquiry project with outcome measurement. The project reflects the student’s area of clinical expertise and is designed to change or substantiate current practice. DNP students are individually supported by expert faculty and clinicians who meet with and regularly
to professional peer‐reviewed journals. At the conclusion of the professional
capstone project, the DNP student must successfully defend this capstone project in a face‐to‐face, publicized, oral presentation open to attendance by the College of Nursing scholarly community. The hybrid delivery format will not necessitate any changes in these established procedures or expectations.
B. Administrative Oversight
Typical DNP course and its delivery method. Each of the required DNP courses will be delivered in a hybrid format with a combination of face‐to‐face (on‐campus) and web‐based instruction and interaction via the Blackboard Learn system. Each organized class course will include a minimum of twelve (12) face‐to‐face contact hours of instruction and learning over the course of the semester. Face‐to‐face contact on campus will also be expected for courses that are classified as DNP practicum coursework and for the professional capstone course. Core DNP nursing courses will be offered in hybrid format, as designated in Appendix B. Other courses, such as electives or courses from other disciplines, may be completely online.
Student introduction to a typical DNP course. The course instructor contacts students by email to welcome them, provides a general introduction to the course, and introduces links to TWU resource tools on web‐based learning. The instructor identifies the date when the course will be available to students within the TWU Blackboard Learn system. The Blackboard site presents an initial announcement that provides a complete introduction to the course and its layout within Blackboard and provides directions on how to effectively navigate through the arrangement of course content. A statement of online learning “netiquette” and related links are included as part of each Blackboard course under a separate navigation button. Students are directed to a Discussion Board area within the course site. The
instructor has posted a statement on the intent of the site to provide students with a “sense of community and open dialogue” within DNP courses. Students are invited to introduce themselves on the site and asked to provide a digital photograph of their choice within this introduction. The instructor has posted a parallel introduction.
Components in a typical hybrid DNP course within the TWU Blackboard Learn System. Each DNP course is divided into sections through separate navigation buttons within the course menu that represent standard Quality MattersTM course architecture guidelines. Some content is available in multiple course locations, as redundancy can be helpful to students who are not as familiar with Internet technologies. A typical DNP course would have the following navigation buttons with specified content:
1. Announcements – This area provides communication from the course instructor to all enrolled students. In a typical DNP course, one or more announcements occur on a weekly basis.
2. Syllabus and Schedule – This area provides the course syllabus, which includes course objectives, DNP program objectives and goals, and related goals
delineated in the Essentials of Doctoral Education for Advanced Practice Nursing (AACN, 2006). Grading criteria and the course calendar with assignment due dates are also part of each DNP course syllabus. Specific TWU policies regarding course attendance, academic dishonesty, and disability support are included within each DNP course syllabus.
3. Start Here – This area provides a specific starting point for students entering the course.
4. Faculty Information – This area provides a photograph of the faculty member with contact information.
5. Course Policies – This area includes course policies for the specific course. For instance, information regarding availability of the course faculty may be included here. Other areas include instructions on Discussion Board communication, how to access support when technical difficulties occur, Internet etiquette,
technology requirements, and a general folder on where to get help, if needed. 6. Discussion Board – All DNP courses include Discussion Boards such as: (a)
Student Introductions, (b) Students Helping Students, and (c) Frequently Asked Questions. Courses may have other assigned Discussion Boards, depending upon course content.
7. Tools – This area provides access to the many online education tools available through the Blackboard Learn system. These include the calendar, blog tools, wikis, podcasts, email, Blackboard Collaborate classrooms, Blackboard IM, and student grade access.
8. Modules – A typical DNP course module has four content areas: (a) Learning Unit, (b) Module Assignments, (c) Module Resources, and (d) Module Video (optional).
a. Each Learning Unit is comprised of a sequence of webpages that present an introduction to the module content, objectives (AACN Essential objectives, TWU DNP Program Goals, Course Objectives, and Module Objectives), module readings, and a learning guide that integrates module activities with the text, assignments, and evaluation strategies for assignments. The learning unit may contain graphics and pictures to illustrate content. Links to pertinent webpages and digital video are embedded within each Learning Unit. The DNP student has the option of printing each Learning Unit in portable document format (pdf), if desired. This pdf has the ability to be presented orally through a computer‐
generated voice.
b. Module Assignments is a list of all assignments with grading criteria rubrics for each assignment. These grading criteria rubrics were
previously presented within the course syllabus. Written assignments are submitted through the Blackboard assignment function. Module tests are also available in the Assignments area. Generally courses that include testing as an evaluation strategy include sample self‐tests.
c. Module Resources may include readings, Internet webpage links, lecture guides, podcasts, and specific content for each course (e.g., SPSS data files).
d. Digital Video (optional) has links to video of previous lectures of TWU faculty, content experts, and DNP student presentations. Digital video is password protected, and opens within the Windows Media Player. (MPEG‐4 and Apple technology formats are also available, if needed.) DNP students can follow these video lectures using the lecture guides available under Module Resources.
9. Sample Papers – This navigation button provides access to selected exemplars of previous DNP student work. Permission has been obtained from the author to use the exemplar within the DNP Blackboard course.
10.DNP Graduate Digital Portfolios – This navigation button provides access to the digital portfolios of previous DNP graduates. Permission has been obtained from each DNP graduate to display the digital portfolio within the DNP Blackboard coursework or DNP organization sites. DNP digital portfolios are a series of webpages that contain the following content for each graduate: (a) introduction to the portfolio, (b) DNP graduate’s curriculum vita, (c) DNP graduate’s
professional goals, (d) exemplars of work from each DNP course, (e) publications, (f) the professional capstone project, (f) video of the capstone project, and (f) professional posters.
11.Course Evaluation ‐ This navigation button is made available at the end of the semester and contains links to course evaluation surveys used to critique and improve each DNP course for subsequent classes.
DNP course modules are introduced in the initial face‐to‐face sessions at the beginning of each semester. Students are instructed on how to prepare for future class assignments (e.g., presentations of case studies during DNP practicum
coursework). Students may also participate in interactive instruction using Internet conferencing and Blackboard Collaborate classrooms. These synchronous
educational methodologies may be used on a weekly or biweekly basis for each DNP didactic and clinical course, allowing the student the opportunity for simultaneous dialog with DNP faculty and fellow students during the semester. The course learning objectives are reviewed to help frame the dialogue with students. Faculty and students refer to a prepared feedback rubric to guide peer critique and facilitate optimal learning exchanges.
At the end of the semester, the instructor provides a comprehensive critique of each student’s final project. Further analysis of the project through webconferencing is
available, if needed. Synchronous scheduling fosters mentoring relationships among DNP students, graduates, faculty members, and community leaders.
Blackboard Learn System and distance education technologies. Web‐based
instruction, student learning, and interaction in organized class courses will occur via the internet using the Blackboard Learn system as the delivery platform.
Contemporary textbooks and literature from professional journals will be incorporated into each course. Copyrighted materials will be included on the website subject to all laws pertaining to use of such materials for educational purposes. Graphics, digital video of student, faculty, and guest presenters, and photos used for teaching will be used in accordance with current laws and
guidelines. Reading and other learning materials will be supplemented with state‐ of‐the‐art synchronous and asynchronous web‐driven learning tools (e.g., podcasts, Internet conferencing).
DNP courses require a high level of analysis, discovery learning, and synthesis on the part of each DNP student. In addition to materials placed in Blackboard Learn,
faculty may use a variety of synchronous methods to communicate with individuals
or groups of students such as phone conversations, Internet video conferences, and Blackboard Collaborate. These technologies assist DNP students to develop the desired “sense of the scholarly community.” Student interactions are also promoted through content‐driven blogs, discussion boards, and wikis. During the capstone course, each DNP student participates in Internet conferences with capstone committee members to review student work. Many of these technologies have been piloted successfully to augment the current face‐to‐face DNP program. These successful experiences facilitate the seamless integration of the proposed hybrid curriculum.
Sustained interaction (Faculty‐Student and Student‐Student). A variety of
synchronous and asynchronous methods will be used within each course to facilitate sustained interaction in the coursework. Each course will include a progression of assignments paired with scheduled Internet conference meetings or Blackboard Collaborate classrooms for both instructor‐student and student‐student
synchronous communications and educational experiences. Students will be advised of the dates and times at the beginning of the course to allow for organization of schedules around the Internet conference or Blackboard Collaborate classroom. These synchronous events will also complement the face‐to‐face meetings and add another layer of personal, real‐time interaction.
Asynchronous discussion areas will allow communication among students and between the students and the instructor that is not dependent upon location, day, or time. Faculty will incorporate a variety of other asynchronous group media tools to stimulate learning and interaction (e.g., discussion boards, wikis, and blogs ). The
selection of each modality used in the course will be driven by the content and learning objectives and the potential of the modality to provide the optimal learning experience and student‐student, and student‐instructor interactions. (See Sections IV.B. and VIII.E.2. for additional discussion on student interaction.)
Anticipated student‐faculty ratio. It is anticipated that the required DNP didactic coursework doctoral courses will maintain a 10:1 student‐faculty ratio. The DNP practicum and capstone courses typically maintain a 3:1 or 4:1 student‐faculty ratio.
C. Administrative Structure
The Graduate School and the College of Nursing have direct responsibility for the general administration of the DNP program. Oversight is provided collaboratively by the College of Nursing Dean, Associate Deans, and the DNP program faculty.
IV. Relationship to Existing Authorized Doctoral Programs
A. Relationship Between Proposed Distance Education Program and Existing
On‐Campus Program
The proposed hybrid delivery DNP program, which will completely replace the existing program, will offer the same curriculum and course sequence as the current program. The conversion to hybrid delivery will have no negative effect. The
inclusion of the current students with students in the hybrid program through extra‐ curricular activities will afford both groups the opportunity to interact within a broader range of students of varied backgrounds. Students beginning the second DNP year will be completing the last DNP didactic course, NURS 6163, Health Outcomes: Measurement, Management and Analysis by summer 2012. This course will be offered in the traditional face‐to‐face delivery method. These students will transition to the DNP practicum and capstone courses in the fall of 2012; practicum and capstone courses are not affected by the change to the hybrid delivery method.
B. Student Interaction
Current DNP face‐to‐face program students will have access to the web‐based student interactive sites that are available to the proposed hybrid delivery students. Entering students in the proposed hybrid DNP program will be invited to an
orientation which will include an overview of library services and technical support for distance coursework. This orientation will be available through Blackboard Collaborate.
Faculty and library personnel will provide student‐directed access to desired skill‐ based training (e.g., data base searching, electronic access to TWU library, and use
of personal citation management tools). These planned training opportunities will be based on student needs and interests and will be sequenced across the course of the curriculum.
Additionally, a DNP Student Forum site has been created. The DNP Student Forum Blackboard site is available only to students enrolled in the DNP program and DNP faculty and staff members. All student‐related documents are posted within this site (e.g., DNP Student Handbook, Degree Plan, IRB Application Materials and
Procedures, samples of successful IRB applications, and DNP graduate digital portfolios). This site meets a logistical need and provides a practical mechanism to promote interaction among students.
The DNP Student Forum contains a navigation menu with the following content: Announcements
Curriculum Information and Program Progression o DNP Student Handbook
o DNP Faculty o DNP Clinical Sites o Course Schedules
o Text Book Requirements o Forms and Documents o Commencement Process Links to Useful TWU Websites
o Bursar/Cashier o Graduate School o Library o Scholarships/Financial Aid DNP Opportunities o DNP News o Career Opportunities o Scholarships/Traineeships o Presentations by DNP Students o Organizations for DNP Students o DNP Student Grants
o DNP Annual Symposiums Alumni Updates
Digital Portfolios (past graduates) Discussion Boards
o Student Exchange
o Open Forum for Questions from faculty
V. Expected Enrollment
A. Anticipated Head Count
The third cohort of DNP students began coursework in the DNP program in June 2011. The first class of 16 students entered as a full‐time cohort in June 2008. Since that time, more DNP students have chosen part‐time articulation. Table 3 illustrates DNP enrollment in courses and graduation for the past three years.
Table 3
DNP Enrollment and Graduation (2008 to 2011)
Academic Year Fall Spring Summer Unduplicated
Count Graduated 2007‐2008 NA NA 16 16 0 2008‐2009 17 25 28 31 0 2009‐2010 30 34 22 38 13 2010‐2011 27 28 27 39 9
Table 4 reflects the number of students admitted to the DNP program, the number of students admitted who did not enroll, and the number of students who withdrew from coursework. In all but one instance, course withdrawal occurred early in the first DNP course. The most frequent reasons cited for withdrawal were health problems and financial problems. During the 2011 fall semester, 32 DNP students will continue articulation through DNP courses, and 5 DNP students will be admitted to the program. With implementation of hybrid delivery of the DNP program, the proposed increase in enrollment will be 25 new admissions per academic year. Table 4 DNP Student Admission, Enrollment, Withdrawal, and Graduation (2008 to 2011) Admit Semester Number Admitted Number Withdraw Did Not Enroll Semester Graduated Number Graduated Summer 2008 17 2 0 May 2010 Aug 2010 Dec 2010 11 1 1 Fall 2008 2 0 0 May 2011 1 Spring 2009 6 1 0 May 2010 May 2011 1 3 Summer 2009 8 1 2 May 2011 Aug 2011 2 2 Fall 2009 4 0 1 Spring 2010 5 1 1 Summer 2010 8 2 2 Fall 2010 3 0 0 Spring 2011 3 0 0 Summer 2011 10 0 0 Fall 2011 5 0 0
Anticipated annual enrollment will be 25 new students. Students can choose full‐ time articulation and complete the degree in 24 calendar months. DNP students can also chose part‐time articulation with degree completion planned within 32 to 36 months. During the last two semesters of the DNP curriculum, most DNP students are enrolled in the DNP practicum, capstone, and elective coursework, maintaining at least 8 credit hours each semester. The anticipated admission numbers are conservative and are based on reliable sources of data from other doctoral programs when coursework changed from face‐to‐face delivery to hybrid delivery.
B. Impact on Existing Face‐To‐Face Program
The hybrid delivery program, which completely replaces the current program, will produce an increase in both numbers of DNP students and semester credit hour production. Existing administrative support will be continued. Additional funding will not be needed for clerical assistance or other non‐faculty resources such as space or equipment to support this growth. The program has a full‐time clerical assistant and adequate space and equipment to support growth.
C. Student Projections
TWU requires a minimum of six (6) students in graduate‐level courses. The projected enrollment of 25 new students every academic year will satisfy this minimum (See Table 5). Demonstrated student desire to enroll in hybrid delivery doctoral courses provides strong evidence that there will be sufficient students to ensure the economic viability of the hybrid delivery program. Actual applications and subsequent enrollment data from the initial DNP coursework to the present provide sound evidence for the program’s growth. (See Section V.A.)
Table 5 Projected DNP Enrollment and Graduation Numbers Academic Year New students (FT and PT) Returning Students
Expected Attrition Graduating
Students Y1 12‐13 25 24 2 12 Y2 13‐14 25 35 2 18 Y3 14‐15 25 30 2 20 Y4 15‐16 25 33 2 20 Y5 16‐17 25 36 2 20
VI. Faculty Resources
A. Faculty Resources
1. Faculty credentials, specialty/contribution, related courses, and current
program Involvement. All College of Nursing faculty members hold current unencumbered RN licensure, have graduate degrees in nursing, and teach in their area of expertise (see Appendix D). A particular strength of TWU is the predominance of College of Nursing faculty with doctoral preparation. The Dallas campus has 19 faculty members prepared at the doctoral level; the Denton campus has 12 faculty members prepared at the doctoral level, and the Houston campus has 26 faculty members prepared at the doctoral level. Nineteen of these 57 faculty members with doctoral preparation are also recognized by the Texas Board of Nursing as Advanced Practice Registered Nurses. All DNP faculty members who participate in DNP practicum courses are clinically current advanced practice nurses with doctoral preparation, national certification, and Texas APRN licensure. The current Coordinator of the face‐to‐ face DNP program is a Certified Nurse Midwife with a PhD in Nursing. College of Nursing faculty members are allowed protected practice time within the context of a full‐time workload, which is a strength that promotes recruitment,
retention, and clinical currency of DNP faculty. Current DNP faculty members and faculty from other colleges who teach required DNP coursework are listed in Table 5 with credentials, rank, certification, specialty, coursework, and role in the DNP curriculum. Additional qualified College of Nursing faculty may teach in the DNP program as needed. Qualified adjunct faculty are used as necessary to amplify faculty resources.
Allocation of faculty resources. All faculty members are appointed on 9‐month contracts; the dean and associate deans hold 12‐month appointments. Each associate dean identifies needs for adjunct faculty for upcoming semesters and presents a request to the dean for allocation of these funds. The CON is
currently interviewing full‐time DNP faculty applicants, and one additional faculty member will join the DNP faculty. DNP faculty‐to‐student ratios meet or exceed the requirements of regulatory agencies and professional nursing standards and are adequate to provide satisfactory student supervision. The number of DNP faculty who are clinically‐current, advanced practice nurses with doctoral preparation is a primary strength of the TWU DNP program.
2. Faculty training in Distance Education. Distance education faculty at TWU have numerous training and educational opportunities to improve technical skills for teaching online. TWU’s Instructional Support Services (ISS) unit offers a variety of training sessions on the technical aspects of the current Course Management System (Blackboard). Web‐based resources are also available to support faculty
using Blackboard. Instructional Technology Services (ITS) provides a Help Desk service. Faculty may use the telephone, chat, or email to receive assistance during regular business hours.
TWU’s Office of Distance Education (DE) provides a variety of services to educate faculty on promising practices in course development, distance delivery, and online pedagogy. DE provides numerous webinars on distance education topics throughout the academic year and coordinates the Online Educator Symposium each August to bring distance education faculty together to learn from each other. In the spring, DE also sponsors the eLearning Lecture series to focus on a topic pertinent to DE faculty. DE also provides several programs that provide specialized faculty development to faculty members and programs converting existing courses and/or programs to distance delivery.
DE also coordinates the Quality MattersTM (QM) Program at TWU. TWU has been an institutional subscriber to Quality MattersTM since 2007. TWU has an Institutional Representative and Certified QM Trainer, conducts its own QM‐ recognized training, and is moving to managing independent QM reviews. More than 85 faculty members and staff at the institution have gone through the training on Using the Quality MattersTM Rubric. More than 40 faculty and staff are QM certified peer reviewers.
The DNP program intends to submit a four‐year program level plan for implementation of Quality MattersTM. Key elements of the plan include: 4 informal reviews of DNP courses per year for three years, 4 formal reviews of DNP courses per year for three years , and a commitment to have all faculty teaching in the program complete the Applying the QM Rubric workshop and the QM Peer Reviewer Certification training. At the conclusion of this three year period, the DNP intends to have 11 courses that have met expectations of the formal Quality MattersTM review process.
The Office of Distance Education is the home to the TWU Instructional Design (ID) group. This group provides direct support to distance education faculty members and programs. Instructional designers are well versed in the distance education literature and assist faculty to plan, design, and manage courses using the best available practices and resources. ID provides a comprehensive set of web‐based resources to support faculty with teaching and learning at a distance. ID also supports the synchronous tool in use by DE courses (Blackboard
Collaborate). Faculty members are trained on sound pedagogical strategies using this tool.
Members of ID will work with the DNP Coordinator to create a series of workshops focused on instructional options for faculty teaching in the DNP
program. Given the strong research and clinical components, students will benefit from careful planning and attention to these elements. Planning and implementation will ensure that students in the program will undergo the types of experiences unique to a doctoral program. Faculty will also learn how to structure instructional activities to prepare students to assume roles as teaching faculty in the future. Collaboration, problem‐solving, scholarship, and reflective practices are all important teaching goals to prepare these students properly.
In addition to the staff on the Denton campus, the Office of Distance Education has an Instructional Designer III located at both of TWU’s centers in Dallas and Houston. These personnel are available to faculty in the DNP program to
develop the structure and consistency needed for the online components of the hybrid DNP program. DNP program faculty members also have access to the full ID group to work on activities and structures for the face‐to‐face components of the program.
3. Support for start‐up development of courseware. Initial support will be
provided by the TWU ID, DE, and ISS teams at no additional cost to the program. Instructional designers will address pedagogical issues and generate alternative instructional options to support faculty. The faculty member will plan and design the instructional sequencing of the course through collaboration with the ID and ISS personnel. Technical support for Blackboard will be provided by ISS, with pedagogical support provided by DE.
B. Equipment, Software, Connectivity Needs
Because this program is using Blackboard Learn as the major delivery system, students are subject to the same hardware requirements as other students at the university. No special hardware requirements are anticipated for students to access and use Blackboard. The hardware and software specifications are available at http://www.twu.edu/de/computer‐requirements.asp. Students may be expected to purchase a standard headset with microphone for any webconferencing sessions in Blackboard Collaborate.
C. Facilities, Equipment, and Library
The TWU Blagg‐Huey Library offers excellent support to faculty and students. The library supports the research and education of students, faculty, and staff with holdings of journals, books, and materials in electronic format, which are available through the Libraries Online Catalog. Students can access the resources needed to complete assignments from any location at any time. Information is available from a collection of 580,000 print titles. TWU subscribes to 180 databases which include
