The Texas Board of Nursing has put a temporary stop to McLennan Community College enrolling new students in its associate degree of nursing program after three years of substandard exit test scores.
The board, meeting Thursday in Austin, downgraded status of the MCC program from Full Approval with Warning to Conditional Approval and set an 80 percent first-time pass rate for this year’s graduates to return the program to full approval status.
The associate degree of nursing program takes two years and leads to licensing as a registered nurse upon passing the National Council Licensure Exam.
MCC President Johnette McKown said the drop in approval status is “concerning,” but that changes to the program have been underway for the past two years in an effort to address exit exam scores and other concerns the state board has. She expects the program to meet the 80 percent pass rate and emerge stronger as a result of the board’s efforts, McKown said.
“We’re very proud of the program and the work that (Health Professions Dean) Glynnis Gaines and (associate degree nursing director) Becky Griffin have done,” she said in an interview earlier this week.
The board’s action does not affect students already in the associate degree nursing program or other MCC health professions programs, which include two other nursing programs. It also does not affect accreditation through the Accreditation Commission for Education in Nursing.
The Texas Board of Nursing has two other nursing programs on conditional approval status.
The board action follows a drop in MCC students’ exit exam scores that started in 2016, when the pass rate dropped markedly to 64.04 percent of 114 students tested, from 86.96 percent of 115 students the previous year. The subpar scores continued , with a 77.88 percent pass rate in 2017 and a 76.47 percent pass rate last year.
The state board changed the nursing program’s status from Full Approval to Full Approval With Warning in January of last year, prompting a campus visit in September and interviews of nursing students, faculty and administrators.
The program will not enroll new students this fall after admitting 40 students this month. The enrollment hold means there will be no graduating class in spring 2021.
Staff and faculty will use the time to evaluate the level-to-level progression in the curriculum, McKown said.
“It will give us an opportunity to retool and to align our classes,” she said. “No one loses their jobs over this.”
Test scores for the 29 students who graduated in last month and 33 expected to graduate in the spring will be reported to the state board by September. If the program meets the state’s 80 percent passing standard, it can enroll new students in spring 2020. If not, the ban on new enrollment will continue for a year.
Vice President of Instruction Fred Hills said students who had planned on enrolling in the associate degree nursing program in the fall may consider other options, including the one-year vocational nursing program that leads to a certification as a licensed vocational nurse, or the Bachelor of Science in nursing program that leads to finishing work with MCC four-year partners Texas Tech University or Tarleton State University.
Although many of MCC’s associate degree nursing graduates find work as RNs in Waco hospitals and clinics, it is not clear if a reduction in MCC-trained nurses would have affect local hiring. Baylor Scott & White Health spokesperson Megan Snipes said the company does not track incoming RNs by where they were trained. Providence Health Center Hospital and the Family Health Center did not reply to questions about RN staffing.
Eight RNs work for the Waco-McLennan County Public Health District, but their positions are somewhat specialized and turnover is low, health district spokesperson Kelly Craine said.
Baylor Scott & White released a statement Thursday supporting the MCC program.
“We are aware of the steps MCC’s leadership has taken to improve the program and we are appreciative of their dedication to educating and equipping students to become exceptional nurses,” it said. “We applaud the school’s efforts to continue providing well-qualified candidates to hospitals that serve our Central Texas community.”
Griffin, an RN, taught nursing at MCC as an adjunct for 11 years and full-time for more than 30 before becoming program director in April 2017. She, McKown and Hills said several factors had converged in recent years to cause what MCC Board President K. Paul Holt called a “hiccup” in the program.
The Texas Board of Nursing adopted Texas Concept-Based Curriculum as the new state curriculum in 2013, around the time state legislators cut back the number of class hours required for an associte degree in nursing from 72 to 60, effectively increasing the amount of material covered while reducing the time to cover it.
Some faculty had difficulty adjusting to new teaching approaches in the curriculum while students complained of inconsistencies from one level to another in the program, the board reported based on its campus visit in September. The board also found that 27 students who had failed the program in fall 2016 were reinstated by the MCC administration. McKown said some students had been allowed to repeat their final semester in hope of passing.
Since 2017, six nursing faculty had left or retired and been replaced by new staff. There are now 20 full-time faculty, 20 part-time faculty and a simulation lab manager.
The program has already added higher entry requirements, a new entrance exam and held a training faculty session with a consultant.
The changes have reduced the annual number of associate degree nursing graduates from slightly more than 100 to about 60 this year.
“There’s decreased enrollment so we can better focus on the students,” Griffin said.
McKown said she has met with local hospital executives to explain the situation.
“They were all very supportive of what we’re doing and understanding these things happen in nursing programs and hospitals,” she said. “They’re fully prepared to hire our graduates. That’s important to us.”