Authors

  1. MacDonald, Angela DNP, RN
  2. Pusey-Reid, Eleonor DNP, MEd, RN

Article Content

Most nursing programs in the United States are regulated by a nursing regulatory body (NRB) such as state boards of nursing. NRBs are jurisdictional governmental agencies in states, districts, and US territories that are responsible for regulating nursing education and practice.1 By regulating, approving, and monitoring nursing programs, the state regulatory body is verifying that the graduates from that program are clinically competent and safe for practice. Some state NRBs also require nursing programs to be accredited by a national nursing accreditation agency to maintain approval.1 Program policies are one aspect of nursing programs that are commonly regulated by NRBs and evaluated by accreditation agencies to ensure that they are fair, impartial, set a standard of quality, and are clear in the desired outcome. All 3 national accreditation agencies for nursing programs have standards related to policies (see Supplemental Digital Content, Table 1, available at:http://links.lww.com/NE/B99).

 

There is limited information on the design and development of academic policies in nursing programs. Despite nurse educators' unequivocal and frequent use of policies in their day-to-day interactions to manage students and courses, there are no dedicated resources available in the literature to assist nursing faculty with the development of this skill set. The purpose of this article is to provide guidance to nursing faculty on writing equitable academic policies for schools of nursing.

 

Policy has several definitions depending on how and in what context, culture, or manner the policy is used. Overall, policy refers to a standing principle or decisions that serve as guidelines for action.2 Academic policies act as guidelines for students and faculty to understand their responsibilities and processes to follow. Policies are explicit statements that create the framework for an action or an expectation for the students. They are a linear description that is rational and identifies a formalized process related to rules and regulations.3 Policies have several purposes: they set expectations for students, provide direction and structure to faculty and administrators, and, when well written, provide faculty with the ability to implement equitable and uniform responses to certain situations consistently. Policy development should involve faculty, leadership, students, and legal counsel.

 

Many nursing program policies contain language that is ambiguous, conflicting, conditional, discretionary, and inconsistent with the policies of the parent institution. As faculty write and review policies, they need to be cognizant that these should be operationalized in ways that show integrity, clarity, and equity because they guide and regulate the programs and course offerings for students. Policies that are not correctly developed bring about confusion, misinterpretation, and inconsistent application of rules, and they create inequitable implementation for the students. This also leads to frustration for faculty and students because there is too much room for interpretation. The decision becomes the responsibility of the faculty rather than based on a clear-cut criterion that guides decision making.

 

Characteristics of Good Policies

Nursing academic policies are not static; they should be developed and reviewed frequently and systematically. Policies are salient statements that should be written in a clear, simple, and concise manner.3 The policy statement should address the rule and how the rule will be implemented. Policies should be readily available to all persons to which it applies, and their authority must be clear. These statements represent a consistent, coherent, logical, and equitable framework for program and course actions.3 For example, a progression policy should tell students exactly what grade is required in the nursing course and what they need to do if they do not achieve that grade, for example: A student must achieve a 75% (C) or higher in all required nursing courses. Any required course in which a student earns a grade below 75% must be repeated.

 

When a policy is to be applied the same way in every situation, it is imperative to ensure that the language is clear. A policy that allows for exceptions or can be adjusted is one that cannot be implemented in a fair and equitable manner. Faculty should avoid using conditional terms such as "may," "some," or "could." An example of a policy that cannot be applied in a consistent manner is as follows: Students who miss an assignment may make it up at the discretion of the instructor.

 

Using Data to Inform Policies

Policies should not rely on faculty or program administrator feelings or opinions about a particular situation. They should be clear-cut, equitable, and focused on achievement of student learning outcomes. A systematic evaluation of program policies ensures that data specific to student outcomes are collected, analyzed, and used to determine the effectiveness of a policy and its consistent application. Each nursing program has a unique student population. By using the program's own data to inform policies, the faculty can develop and implement policies that are focused on student outcomes rather than on arbitrary criteria related to their own personal biases (see Supplemental Digital Content, Table 2, available at: http://links.lww.com/NE/B100).

 

Data collection should include several methods for each component of the program and include direct (eg, student grades, success on National Council Licensure Examination [NCLEX]) and indirect (eg, faculty and student perceptions) methods whenever appropriate. Many policies have the main purpose of ensuring that a student develops competence and achieves the established learning outcomes of a course and the end of program student learning outcomes. However, they often contain conditional terms that leave the policy open for interpretation such as: "at the discretion of the instructor"; "may result in termination from the program"; or "extenuating circumstances." A policy that contains conditional language cannot be applied consistently and equitably because it allows the outcome to change on the basis of the interpretation of the faculty or administrator who is applying it. If the true intent of the policy is to ensure that students are able to meet outcomes, data must be used to determine when that outcome cannot be met.

 

When examining the data, it is important to look at not only student information but also the availability of fair and equitable distribution of resources. Data that would be useful for evaluation of policies correlate with scores on clinical evaluation tools, examination grades, final grades in the course, and even first attempt on the NCLEX. The program should use at least 3 years of data to make decisions about policies as per practices of the accrediting bodies.

 

Other issues with unclear language in policies are that it allows faculty and administrators to make determinations about whether or not something is acceptable or important. When a faculty member has discretion to determine if a student is allowed to make up clinical time or assignments, progress in the program, or what the consequences will be for situations such as cheating, they may use their own personal experience or bias to make that decision. An equitable and fair policy eliminates this and focuses on the true purpose of a policy, which is to ensure that a student can meet the required outcomes and competencies.

 

Conclusion

This article contributes to the understanding, description, clarification, and development of nursing academic policies that are equitable and that can be evaluated for effectiveness. Examples of clear language that allows faculty to apply policies the same way for every student are provided. Policies should never be developed on the basis of faculty opinion but rather on clearly established data collection methods and the analysis of those data. Regular and systematic evaluation of nursing program policies using data strengthens those policies and ensures equitable application.

 

References

 

1. National Council of State Boards of Nursing. Requirements of national nursing accreditation for prelicensure programs. 2021. Accessed September 1, 2021. https://www.ncsbn.org/665.htm[Context Link]

 

2. Mason DJ, Perez A, McLemore MR, Dickson E. Policy and Politics in Nursing and Health Care. 8th ed. Elsevier; 2020. [Context Link]

 

3. New York University. University policies. 2018. Accessed September 1, 2021. https://www.nyu.edu/about/policies-guidelines-compliance/policies-and-guidelines[Context Link]