Distant Learning Master's Degree Program for Nurse Midwives and Nurse Practitioners

Master's Degree Program for Nurse Midwives and Nurse Practitioners and Distant Learning

Frontier School of Midwifery and Family Nursing,History of Distant Learning at Master Level,Strategic Planning Goals for MSN Program,Design, Implement, Evaluate, and Improve the Revised Graduate Curriculum.

Frontier School of Midwifery and Family Nursing

    The purpose of this chapter is to provide an update on the progress of the development of an innovative distance education program for nurse midwives and nurse practitioners at the Frontier School of Midwifery and Family Nursing. 

    The establishment, early development, and operation of the Community-Based Nurse-midwifery Education Program (CNEP) were described in an earlier edition of this book (Stone, Ernst, & Shaffer, 2000). 

History of Distant Learning at Master Level

  The Frontier School of Midwifery and Family Nursing (FSMFN) is a private, nonprofit, nonresidential, community-based distance-education graduate school offering a master of science in nursing degree and certificates in advanced practice specialties. 

    The focused mission of the school is to provide a high quality education that prepares nurses to become competent, entrepreneurial, ethical, and compassionate nurse-midwives and nurse practitioners who will provide primary care for women and families residing in all areas, with a focus on rural and medically under served populations. 

    The program is designed to offer greater flexibility in graduate education for mature, self directed adult learners who prefer independent study or who are unable to relocate to existing programs that offer the nursing specialties provided in this program. 

    It is a graduate program based on the concept of community based distance learning, a “university without walls.” One fundamental concept of a community-based education program is that students learn best in their home environments.

    They do not leave the community they plan to serve in order to gain nursing midwifery or nurse practitioner education, and they use the resources of that community as part of their learning environment.

    The school operates community based programs that consist of four levels of instruction. All courses in Level I, II, and IV are offered year round with the student able to start and finish a course on his or her own schedule. Level III requires a 2 week on campus residency. 

    All students come to the Hyden, Kentucky, campus for Frontier Bound, a 6-day intensive orientation to the school that includes introduction to all Level I course by the faculty, meetings with advisors, computer and library instruction, and, most importantly, bonding with each other and the faculty and staff so that they will not feel isolated when they return home. Students return home to complete Web based courses for Level I, the foundational courses for practice; and Level II, the foundational courses for management. 

    Students interact with each other, faculty, staff, and alumni using the FSMFN Web portal system, named the Banyan Tree, for course work, social support, and scholarly inquiry into practical issues. The student returns to campus for Level III, a 2-week intensive skill training and verification experience. Level IV focuses on clinical practice and the course work that is best suited for learning while in practice. 

    The clinical practice is done in a community based clinical site that has been evaluated by the Frontier faculty and deemed an appropriate site for learning. Students are guided in the clinical area by expert clinical faculty. Problem solving and developing independent decision-making are integral parts of the clinical practicum. 

    They are seeing patients, making diagnosis and management decisions, and, if a midwifery student, assisting mothers during childbirth. Students have a minimum of 675 hours of clinical practice as part of their course of study.

    After completing their clinical courses, including the preceptor's signing a Declaration of Safety, the student takes a comprehensive examination covering all course work. Passing the exam leads to graduation. Although the formal graduation ceremony occurs only once each year in October, a student graduates on the day the faculty member verifies that the student has passed the comprehensive examination.

    More than 1,070 nurse midwives have graduated from this program, representing every state in the nation. In 2000, FSMFN began the Community Based Family Nurse Practitioner Program (CFNP), making family nurse practitioner education available through community-based learning. As of fall 2004, 24 family nurse practitioners have also graduated from this program. 

    The innovative, nonresidential, community based program allows nurses to become advanced practitioners using their own communities as their classrooms. During the 1990s, the school's focus was the implementation of the highly successful CNEP program for nursing midwives. 

    The program was a certificate program with an option for completing a master of science in nursing degree through an affiliation agreement with the Frances Payne Bolton School of Nursing at Case Western Reserve University (FPBSON/CWRU). Students earned the MSN by completing nine credits for three courses that are offered several times a year in 1 and 2-week course intensives on the FPBSON/CWRU campus in Cleveland, Ohio. 

    When the CFNP program was developed based on the CNEP model, the affiliation agreement was extended to include the CFNP students. For the nurse midwifery students, completing the MSN was an option, depending on the requirements of the state where they lived, because in most states nurse-midwives could practice with a certificate. For the CFNP students, the MSN was mandatory in order to be eligible to sit for the national certification examination.

    The FPBSON/CWRU affiliation was a wonderful asset to the program because FSMFN did not have institutional accreditation and could only offer certificate programs. As master's education for advanced practice nurses became the norm in the late 1980s and through the 1990s, this became an essential component of education for nurse midwives as well as nurse practitioners. 

    More than 80% of the CNEP students took advantage of this option and went to Cleveland to complete their MSN.The early CFNP graduates all completed their MSNs through this affiliation. But as the geographical location of the students expanded to include all of the United States and seven foreign countries, the ability of students to go to Cleveland to complete intensive, on-campus courses declined. 

    The FSMFN board of directors and administration recognized that this was becoming more and more of a barrier for students. Students and graduates asked, “Why can’t we do the MSN courses at Frontier?” 

Strategic Planning Goals for MSN Program

    In 1999, the FSMFN board of directors, administration, and faculty began strategic planning sessions with a focus on the development of a master of science in nursing program with tracks in nurse midwifery and family nurse practitioner education. There was a lot of work to be done. 

    The goal was to provide a superior education using distance technologies, allowing students to remain in their home communities as much as possible during their education. Twelve strategic planning goals with a 5-year timeline were developed and approved by the board of directors. The rest of this chapter outlines those objectives and the progress made. 

Design, Implement, Evaluate, and Improve the Revised Graduate Curriculum

    Recognizing that the first step in the path toward full accreditation must be to develop the MSN curriculum, a major revision to the curriculum was planned and completed in the year 2000. 

    This was necessary to ensure that the curriculum for the planned master of science in nursing (MSN) degree met all of the criteria established for this degree by the Southern Association of Colleges and Schools (SACS), the American Association of Colleges of Nursing (AACN), the American College of Nurse Midwives (ACNM), the National Organization of Nurse Practitioner Faculty (NONPF), the National League for Nursing Accrediting Commission, and the National Certification Corporation for the Obstetric, Gynecologic, and Neonatal Nursing Specialties (NCC). 

    An eminently qualified nurse educator, Carol Panicucci, PhD, FNP, was hired and appointed as coordinator of graduate curriculum. Her charge was to lead the curriculum review, ensuring that all competencies were met while avoiding duplications. The process included a series of conference calls culminating in an on campus 4-day retreat of the entire faculty. 

    Additions to the curriculum included strengthening the women's health content for the Community Based Family Nurse Practitioner Program (CFNP) and strengthening the primary care content for the Community Based Nurse Midwifery Education Program (CNEP). Two new courses were added to meet the needs of the MSN students for a foundation in theories related to primary care and research. The new curriculum was implemented in the fall of 2000.

    The curriculum committee developed and implemented an annual evaluation process that includes course analysis and review of graduate outcomes, as well as biannual peer-evaluation of each course. Course content is determined by the competencies defined by the professional organizations and by the mission of the FSMFN. 

    In addition, the FSMFN is committed to teaching the principles of effective business management, with the goal that practitioners will have the skills to open and operate their own practices. As each course is reviewed, the faculty member reviews the curriculum map, the student course evaluations, peer reviewer comments, and national exam results and uses these data to plan the course revision. 

    The depth of the review is based on the need that is revealed through this data analysis. When the review is completed, it is sent to the curriculum committee. There, it is reviewed by the coordinator of graduate education and two assigned faculty peer reviewers. The course is made available to all course coordinators, allowing others to assist the faculty member in improving the course. 

    Comments from these reviews are used by the course coordinator to complete the course review. After the course obtains curriculum committee approval, it is sent to the multi-media team who works with the course coordinator to add edits and any new technology pieces that might be requested by the course coordinator. 

    The course is then placed on the FSMFN website. To evaluate the curriculum as a whole, the FSMFN uses a systematic plan to continuously evaluate the MSN terminal and specialty track objectives through 1-year and 5-year graduate and employer surveys, certification results, and comprehensive examination results.