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Kay Trinkle, Debra Bragg, Paula Puckett, and James Jacobs
The college has changed drastically since the 1960s, especially in enrollments (see Table A-11). However, some key objectives have remained constant under the long tenure of CSCC's President. One goal throughout has been "to be the place where the community comes first for its education and training needs." This is an ambitious goal given the large number of higher education institutions in the region. Yet, members of both the administration and faculty said they believe it is an important goal to recognize and serve both their "internal and external customers." Supporting this philosophy, an interest in total quality management (TQM) was evident on campus.
The total head-count enrollment reported for Autumn Quarter 1993 was 17,042 (see Table A-11). The number of persons thought to be served during the previous academic year was approximately closer to 40,000 when all the services of the college were taken into account. There were 9,329 FTE enrollments during that same period, with the last two fiscal years showing increases of more than 2% annually. Minority students represented 15% of the head-count enrollment, with most of those students being African-American. The average age of students was typical of most community colleges in the U.S. at 28. A relatively high proportion of students (29%) were receiving Pell grants. Presently, 182 full-time faculty and approximately 480 part-time faculty teach at the college.
|Enrollment and Student Demographics||Incidence|
|Institution's total head count enrollment||17,042|
|Institution's FTE enrollment||9,851|
|Percent of total student population receiving Pell grants||29%|
|Average age of the institution's entire student population||28|
Chef Apprenticeship Program
The Chef Apprenticeship Program at CSCC is highly regarded and is supported unequivocally by the faculty and administration. When asked what motivated the college to begin the Chef Apprenticeship Program, the President responded, "the community wanted it and local businesses justified the need." A primary goal of the Chef Apprenticeship Program is to provide students with a solid foundation of cooking skills, techniques, and technical knowledge through on-the-job training and classroom instruction. It is to prepare competent cooks who can be certified at the first level of certification offered through the American Culinary Federation Educational Institute (ACFEI) leading to the maximum level, certified master chef. The goal is accomplished through a strong working relationship between the Columbus chapter of the ACFEI and approximately 40 restaurants, hotels, and clubs in the Columbus area.
The program requires 6,000 hours of on-the-job training in food service facilities over a three-year period. Students attend classes one full day per week and work an average of 40-50 hours per week year-round. They earn from 7 to 11 credits per quarter each of 12 quarters, and upon completion, earn an AAS degree in Hospitality Management with a major titled "Chef Apprentice." They also receive certification from the U.S. Department of Labor (USDOL), identifying the apprentice as a journeyman cook. The program's objective is to prepare students for certification through the ACF, which offers certification from the levels of cook through master chef.
Funding of the Chef Apprenticeship Program is based on an average cost of $4,775 per student for 1993-1994; it falls close to the college's average program cost. Program supporters include the local and national chapter of the ACFEI, the Ohio Restaurant Association, and the apprenticeship committee which is made up of executive chefs from the local ACFEI chapter and the chair of the Hospitality Management Department at CSCC, who serves as the Apprenticeship Committee Coordinator. The Apprenticeship Committee also meets with supervising chefs on an annual basis to review training responsibilities and concerns.
One issue facing the Apprenticeship Committee is providing training so that local chefs can improve their performance as workplace mentors. The problem is most serious for chefs who are not active in the local ACFEI chapter but still hire students to work in their restaurants. The Apprenticeship Committee is hoping to use mentor training as a way to resolve problems with a few restaurants or chefs whom students report are difficult to work for. Students hear about these situations and avoid them, if possible. The Apprenticeship Committee has little control over what happens in day-to-day operations at the work site, though they usually can place students in other restaurants if there is a problem with the employer and the student applies for transfer. Training for participating chefs/mentors is a component that the Apprenticeship Committee and the Department Chair are interested in pursuing further. The college is in the process of choosing someone to conduct the training in conjunction with the college's Business and Industry Training Department.
The Chef Apprenticeship Program is currently one of about 100 ACFEI apprenticeship programs in the United States. The CSCC Program is a relatively old program having accepted its first students in 1979. Although the program does not recruit actively, in the Fall of 1993 approximately 100 applications were made for 30 new apprenticeship slots. In that same quarter, there was a total of 87 students enrolled in the program. Chef Apprenticeship students have an average age of 26 years; 7% were African American (see Table A-12). The program graduated and certified ten students in the 1993 academic year. Statistics on retention were not available for the program alone, but the retention rate for the Hospitality Management Department between Autumn FY 1993 and FY 1994 was 32%. According to a CSCC spokesperson, the retention rate for the Chef Apprenticeship Program would be higher than the department because of the lock-step sequence of coursework and apprenticeship training.
|Enrollment and Student Demographics||Incidence|
|Total number of students enrolled in the program||87|
|Percent of students receiving Pell grants||UK|
|Average age of students||26|
|Graduation rate for students||10 graduates|
|Job placement rate for students||UK|
|Transfer rate for students||UK|
The college demonstrates support for the program through strong faculty commitment. It appears well worth the investment if the regular publicity the program receives is any indication of its quality. According to the chair, the Chef Apprenticeship Program is mentioned almost weekly in the local newspaper. As evidence of his enthusiasm for the program, the President of the college spoke of adding a student-run restaurant on the CSCC campus, but the Department Chair reported that this is still in a very early stage of development. She shared her concerns about how a school-based enterprise such as this might affect the program's long-standing relationship with local chefs because it would add competition to the restaurant industry if done correctly. Nevertheless, the administration appeared to be committed to investing even more in the program. When asked if there are barriers to pursuing more work-based learning programs in the college, the President said the only barriers are attitudinal. He said that it is important for his administration to be willing to work hard and have a "do-what-it-takes attitude." His involvement in interviewing and hiring all middle- and upper-level administrative positions is indicative of his hands-on attitude toward management of the college.
The Chef Apprenticeship Program is housed in the Hospitality Management Department and is led by the Department Chair. Four full-time and two part-time faculty teach in the program. This well-established faculty provides a stable developmental environment. Along with teaching, they develop curriculum, market programs, and recruit and counsel students. The Department Chair was part of the planning team that brought the Chef Apprenticeship major to CSCC. She directed the organizational and instructional changes in the current program. Each stakeholder group described the importance of her role in a similar way; it was as the linchpin in the system. In the early stages of developing the program, she did not ask the college for resources, but, rather, went to the community; together, they built the program. She offers the constant, day-to-day leadership that a program involving external partners must have to work effectively. Part of her day-to-day operation is making site visits, meeting with new and more experienced supervising chefs, and developing a working relationship with each participating house (restaurant). Approximately 40 fine dining restaurants in the greater Columbus area have one or more apprentices in each.
One partnership that contributes to the success of the Chef Apprenticeship Program is the one between the ACFEI and CSCC, and it is useful to understand how the ACFEI came into being. According to one of the program founders, during the mid-1900s European chefs quit coming to this country. Educational institutions in the U.S. had not developed the crafts or guild form of teaching which is still strong in Europe today. Chefs in this country realized the shortage of these in the culinary profession and formed professional associations such as the ACFEI. In so doing, the ACFEI followed the European example and developed an apprenticeship program with the help of the Bureau of Apprenticeship and Training (BAT) to satisfy the labor and educational requirements of the USDOL. Out of this cooperation, the National Apprenticeship and Training Standards developed, including the creation of definitions as well as the establishment of qualifications, a wage progression, supervision, and evaluations for apprentices. It also set specific competencies that each apprentice must demonstrate to earn journeyman status. Graduates must demonstrate proficiency in all food production departments in a commercial kitchen and work effectively as a first-line supervisor and trainer in food production.
Based on these national standards, local chapters of ACFEI developed apprenticeship programs. In the late 1970s, the Columbus chapter of ACFEI approached CSCC because the college had established a general program in Hospitality and Food Service. CSCC and the Columbus chapter wrote the Apprenticeship Handbook that includes the guidelines from the national standards, the recommended sequence of study, the design of work-based instruction, and the design of college-based instruction. It includes a comprehensive workbook called the Training Log used to monitor and connect progress between work-based and college-based instruction.
The Columbus Chapter of the ACFEI is vital to the success of the Chef Apprenticeship Program. The ACFEI chapter caters to the college and its students by providing discounted student memberships and holding regular meetings on campus. The ACFEI chapter has joined with the college development foundation to offer a "Taste of the Future," where local chefs prepare their specialties for $75 per plate. Held at the college, this event raises scholarship money for students and gives chefs exposure in the community by offering their dishes outside their own restaurant. In addition to the "Taste of the Future" event, the ACFEI chapter enjoys national notoriety through its award-winning results in national competitions. These events represent another means of giving students valuable exposure to the profession. Another benefit of the close relationship between CSCC and the ACFEI chapter is the development of specific guidelines for apprenticeships in the local community based on the national guidelines.
Another stakeholder group is the fine-dining restaurants in the greater Columbus area. They support the students by paying them for their services. In addition, they provide a limited amount of additional training (estimated at an average of one-half hour per week) to apprentices over their other employees. One chef estimated that the cost of this training is relatively small compared to training someone off the street who is not as committed and also not involved in school-based learning. In return for their investment, local restaurants gain a more dedicated workforce.
Students invest three consecutive years of their life in this program and at the restaurants where they work. To enroll in the Chef Apprenticeship Program, students must be 17 years or older and hold a high school diploma or equivalent. The apprentice is a full-time employee, on-the-job 40 hours a week (2,000 hours per year), and in class at the college one full day a week (an average of 36 credit-hours a year). Several students in the program had already acquired a college degree (including baccalaureate degrees) and were pursuing a second degree, stating they were "looking for skills that could get them jobs."
ACFEI's training guidelines are structured to encourage lifelong learning through recertification and promotion. Students who are active junior members of ACFEI for the latter two years of apprenticeship may also receive the ACFEI qualification of Certified Cook upon graduation. This level is the first of several possible professional promotions through the ACFEI membership; students interviewed understand the structure of this apprenticeship. They were quick to point out that it is not an easy program, working a minimum of 40 hours per week and going to school full-time. One student called it a "focused sacrifice."
School-Based Learning Component
Sponsorship by the Columbus Chapter of ACFEI in the late 1970s and early 1980s included housing classes and supplementing equipment to the college's old home economics kitchen. Chefs served as visiting instructors, bringing with them the fresh fish, meats, or more exotic foods that would be too costly for the college to provide. With the Food Service Program already implemented, only two courses were added to fulfill the requirements of an AAS degree: (1) a course in baking and (2) a course in garde manger (e.g., cold food specialties). Since then, other classes have been added as the partners in the Chef Apprenticeship Program develop better technology, implement improved assessment tools, and arrange more time to collaborate. Currently, the program offers training in areas where some restaurants do not such as baking and pastries and breakfast cooking. In addition to theory, CSCC fills in where the work site cannot offer comprehensive training. Students plan menus, cost out meals, and write advertisements which are all important for running a restaurant. This balancing act is an important ingredient of the program itself.
Today, the Chef Apprenticeship Program curriculum is distributed over three years or 12 quarters, with 6,000 total hours in work-based instruction. The school-based curriculum involves 22 credit hours in general education, 22 credit hours in basic-related support courses, and 66 credit hours in the major, including nine credit hours of co-op work experience. Similar private programs are offered at a cost of $35,000 versus the approximate $3,000 annual cost to a student at CSCC.
An apprentice is assigned to an executive chef at the work site, but signs the Apprenticeship Agreement with the ACFEI Columbus Chapter. This means that the Columbus Chapter assumes the responsibility for on-the-job training. The ACFEI suggests a five-step applicant screening process used at CSCC:
In addition, students are required to take math and English placement tests and complete the application packet which includes a general application to the college.
Work-Based Learning Component
Once admitted, apprentices rotate through ten work stations in a commercial kitchen fulfilling a prescribed list of competencies laid out in the Training Log. The log entries must be completed for each of the ten work stations. Supervising chefs check off the mastery of skills performed in each station. They report different methods of ensuring completion of the log such as weekly meetings, but they must initial that the student has demonstrated competency in each skill. Apprentices are responsible for the log's completion and cannot graduate without it. The Apprenticeship Committee reviews the progress of each apprentice by reviewing the logs every six months. This acts as a motivator to keep student entries up-to-date, while also monitoring the supervising chef's participation.
An advertisement is placed in the chefs' trade publication announcing new apprentices; anyone interested in sponsorship can call. Hiring chefs come to the college, review files, and call to arrange formal interviews at the workplace. They may or may not hire applicants, and students may or may not accept. The understanding among employers is to start apprentices at a minimum of $5.00 per hour with at least a .25 per hour increase for each year the student is in the program.
A supervising chef oversees the students' demonstration of skills and completes a checklist evaluation for each section of the work station. At the same time, students in college-based instruction learn about food service equipment, proper safety, and sanitation methods, and the reason for using the proper techniques. A probation period of 500 hours allows apprentices and supervising chefs to make sure the work experience will be a good fit for both. Students know that questions or concerns encountered at the work site should be addressed through supervising or executive chefs, while questions or concerns encountered at the college should be addressed by the Chef Apprenticeship faculty or Department Chair. Faculty are responsible for the college curriculum; supervising chefs are responsible for carrying out a structured learning experience at the work site. Students are responsible for participating fully in both experiences.
Connecting activities include some of the things previously mentioned such as the Training Log. Chefs and college faculty take a proactive approach to keeping up with student needs by pursuing them if they perceive a problem such as missing work or school. While this is typical of occupational programs, it may create a closed loop by not bringing in outsiders (e.g., counselors) to help address problems. Other resources in the college may not, however, be available to attend to such needs.
Finally, the students themselves provide support for each other; they take the classes and obviously live the same hectic lifestyle. This provides students with a peer group to reflect on what they're learning--an informal, yet vitally important aspect of adult learning.
A real strength of the program rests with the leadership provided by the Department Chair, and her departure appears imminent due to retirement. Another member of the faculty is currently being brought into a leadership role to ease this transition. The Department Chair's shoes will be difficult to fill for numerous reasons. Most importantly, she has built structures and created networks such as the Apprenticeship Committee that are crucial to the ongoing health of the program. Also, her participatory approach to management may be very difficult to replicate. Typical of her supervisory style is a situation described by one of the Chef Apprenticeship faculty. This particular faculty member started with the program ten years ago and she explained that her arrival came at an opportune time to develop assessments for the college side of the curriculum. Her idea was to measure what Chef Apprenticeship students were getting from classes and labs, and to get feedback from chefs and students about areas of improvement. The Department Chair eagerly supported the idea and further suggested the professor visit the participating restaurants to see the commercial kitchens where the apprentices work. This plan brought about a chain of events that led to a continuous improvement process that has had numerous benefits for the program.
No matter who leads the program, challenges lie ahead. Some students interviewed were aware that their particular restaurant provides better (or worse) training or feedback than others, raising the question of whether the work experience should be uniform for all apprentices in the program. Leaders of the Chef Apprenticeship Program believe it should be. They readily acknowledge that the Apprenticeship Committee or the Hospitality Management Department needs to offer workshops or seminars to train chefs on mentoring and evaluating apprentices. In this way, chefs can become more sensitive to student needs and identify a mentoring approach that is workable in their restaurant operations. A barrier to offering such a program is the lack of clear guidelines within the college as to who should be responsible for such training. Should it be the Hospitality Management Department or the Business and Industry Training Department? Other community colleges with growing Business and Industry Training Departments may be concerned about this question. At CSCC, the question had not been answered at the time of our visit. Local program leaders were also concerned about how chefs who may feel they already offer adequate mentoring to students would react to such training. Possibly training could be an added prerequisite to any new chef interested in hiring students, thereby avoiding conflicts with the chefs currently active in the program. As several people pointed out, many graduates of the Chef Apprenticeship Program now act as mentors for chef apprentices and, where this happens, students do not have a problem with the work experience they receive. By continuing to feed the chef occupation in the Columbus area, the Chef Apprenticeship Program provides a training ground for students as well as mentors.
Short- and long-range outcomes arose from this round of assessment. First, from the visit to the work sites the professor realized that the equipment class could be modified so that equipment not as available in the work sites could be given more time in lecture and labs, and equipment readily available could be covered with less depth. With the feedback from participating chefs, it was discovered that, generally, knife skills were still a little less polished than they should be by the second year of the apprenticeship. As a result, lab periods were restructured as the kitchen facilities were built so that students would spend more time in demonstration. Labs that had been teacher demonstrations and one hour in length were made three hours in length so students had time to practice their skills in preparing food. Another outcome requires a Sanitation & Safety course be completed early in the program.
The registered apprenticeship model used for the Chef Apprenticeship Program best fits the goals of the partnering associations, the local fine dining restaurants, the federal guidelines to achieve skill standards, the mission of the college, and the students' expectations for careers. In the college-based portion, theory-related instruction provides a well-rounded education; labs provide practice in the areas not covered in all work sites such as breakfast cooking, and the college classroom provides the place for students to network, and serves as a final point of problem resolution for the student. Through the work-based instruction there is the on-the-job training with structured professional supervision, career and technical mentoring, high opportunity for placement at graduation, and opportunity to experience professionalism. In the connecting activities, the Training Log was the link between teachers and chefs, and between performance and evaluation at each site. The Apprenticeship Committee/advisory council was also an important connecting activity that served to review the work-based instruction and evaluation, provide feedback for improvement, and carry a serious amount of responsibility as a partner in the Chef Apprenticeship Program. The final key component is the structure provided by the ACFEI Guidelines that was built upon by the local partners, and the commitment of each partner to fulfill their duties and responsibilities.
Graduates of the Nursing Technology Program receive an Associate Degree and are qualified to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN). CSCC's Nursing Technology Program is accredited by the National League for Nursing and the North Central Association of Colleges, and approved by the Ohio Board of Nursing. Graduates of the program are prepared to assume numerous work responsibilities, including the following listed in the CSCC's 1993-1994 catalog:
Like many nursing programs offered in two-year colleges, the Nursing Technology Program at CSCC has a long waiting list; students are said to have to wait as long as two years to get into the program. The ultimate decisions about admission to the program are contingent upon students meeting a number of requirements (and many students need remediation to meet these prerequisites for entry--reading skills were described as particularly problematic). Listed below are the requirements for admission to the CSCC Nursing Technology Program:
Students admitted to the program are predominantly female and often single parent heads of households. The average age of students in the program is 31 years. The Nursing Technology Program is quite large, enrolling a total of 344 students during the autumn quarter 1993. The demographic composition of the group is similar to the college as a whole (see Table A-13). The vast majority of students are white (80%), although slightly more minority students are served by the Nursing Technology Program. Of those, 13% are African-American, 2% are Asian, and the remaining students represent other minority groups. Students who enter the program have a fairly high rate of completion demonstrated by a graduation rate of 67%. Although job placement is not considered a formal component of the program, the placement rate is exceptionally high at 95% (and this is during a time when the job market for nurses is viewed as being in a down cycle in the local economy). About 21% of graduates transfer to four-year nursing programs for the baccalaureate degree (based on students' plans at graduation). The licensure passage rate has varied over the past decade from a high of 96% to a low of 60%, averaging about 80%.
|Enrollment and Student Demographics||Incidence|
|Total number of students enrolled in the program||344|
|Percent of students receiving Pell grants||UK|
|Average age of students||31|
|Graduation rate for students||67%|
|Job placement rate for students||95%|
|Transfer rate for students (based on student plans)||21%|
The faculty for the Nursing Technology Program is quite large. Sixteen full-time and thirteen part-time faculty are responsible for the program and most have been employed with the CSCC program for a long time. Most hold master's degrees in nursing; a few hold the master's degree in education. The Director of the Nursing Technology Program has a doctorate of philosophy degree in nursing education from a major land-grant research university and has a wide range of experience in the profession, including having held research and teaching positions in her alma mater's major research/teaching hospital. Of course, all of the faculty are licensed to practice registered nursing in Ohio. The faculty actively engage in professional development opportunities (e.g., graduate coursework, seminars, workshops, conferences) to maintain their technical expertise. Members of the faculty have been recognized for their teaching excellence and the department received a commendation for excellence in teaching based on ratings of 4.5 on a 5.0 scale on student evaluations.
As a group, the faculty is highly involved in curriculum development activities to accommodate the rapid changes occurring in the local health-care industry (changes thought to be spreading rapidly throughout major metropolitan areas in the nation). The Director described numerous efforts she and other faculty had undertaken to identify changes in nursing-related occupations and the health-care delivery system in the immediate area. Among the strategies used to collect labor market data were focus groups designed to engage small groups of health-care professionals in in-depth discussions about the changing job market for nurses and implications for curriculum. (Several of the employers involved in the focus group had experience working with recent graduates of the CSCC Nursing Technology Program.) In addition, outside experts had been brought on campus for the specific purpose of providing professional development of the nursing faculty with regard to changes occurring in health care and nursing practices.
Besides these efforts, curriculum development committees were meeting internally and with external representatives of the local health-care industry to make decisions concerning curriculum modifications. A conclusion drawn from these various research activities was that there was a need to provide more cross-training involving other nursing-related occupations. An increased emphasis on critical health care was also identified. In addition, several faculty mentioned the need to prepare students to work in nursing-related occupations in a wider variety of settings than hospitals. Home health care and extended health-care facilities (nursing homes) were frequently mentioned as settings that would have a growing need for registered nurses. These were seen as viable alternatives to the large corporate hospitals in the area that were aggressively downsizing their registered nursing staffs.
The health-care industry in Columbus is large and diverse to accommodate the growing metropolitan population of over one million. The nursing students were working in over twenty clinical settings in the central Ohio area. According to the Assistant Director of the program, who had responsibility for clinical placements, CSCC had a long-standing relationship with most of these health-care employers. Most were actively involved in the program's advisory committee which met routinely to review curriculum and evaluate the clinical placements provided for student nurses. Graduates of the program had assumed positions in many of the local health-care settings, providing a network to assist with classroom and clinical teaching.
Another stakeholder group that cannot be forgotten in relationship to the nursing occupation is the credentialing agencies. For CSCC, the key groups are the National League for Nursing and the Ohio Board of Nursing. These groups set the standards for the nursing occupation and the programs designed to prepare nurses. (Issues related to these licensure boards are mentioned in the "Lessons Learned" section.)
Finally, like any educational program, students are the most important of all stakeholders to the Nursing Technology Program. The CSCC students were highly dedicated to their education and enthusiastic about preparing for a career in the health field. Most had to wait for up to two years to enter the program; however, that delay did little to discourage them from pursuing their dream of becoming a registered nurse. In fact, during the waiting period, some of the students took the coursework to become a nurse assistant in order to gain real-world experience in a health-care setting and enhance their chances of admission to the CSCC Nursing Technology Program. The level of student commitment was impressive given that many had serious economic and academic difficulties that must have made pursuing and completing any kind of formal postsecondary education very difficult.
School-Based Learning Component
Students preparing to be registered nurses in the CSCC program take 52 credit hours in nursing courses combined with 53 credit hours in general education studies, covering seven quarters of formal classroom instruction, laboratories, and clinical experiences. The curriculum parallels the Curriculum Design for Associate Degree Nursing Programs: Teaching and Evaluation in the Classroom, published by the National League of Nursing.
The Director of the Nursing Technology Program described the curriculum as having three distinct levels tied directly to specific teaching and learning approaches. First, students participate in a somewhat traditional didactic, lecture/discussion experience in the nursing-related classes taught on the CSCC campus. We observed an auditorium full of nursing students (approximately 60 or so) during our visit to the campus. In this particular class, students were given a detailed outline of the instructor's lecture notes which also followed closely with the textbook reading assignment students had been given in preparation for the session. An overhead projector was used by the instructor to provide material visually during the presentation. Even though the class was quite large, an active dialogue occurred between the instructor and students. Questions were posed by both the instructor and students throughout the session, and students seemed to feel comfortable speaking up to ask questions or offer answers.
Closely related to this first approach is the laboratory/simulation strategy which provides students their first opportunity at hands-on practice, linking what they learn in lecture-led classes to actual practice. During this phase of instruction, faculty demonstrate appropriate behaviors and guide students to perform certain skills until they reach an acceptable performance standard. At this stage, students practice particular skills in the controlled (low-risk) laboratory setting until they are believed to have a sufficient enough level of proficiency to attempt them with real patients in a (high-risk) clinical setting. We perceived that this laboratory/simulation strategy (apparently used widely in all health-care occupational preparation programs) provided an excellent means of systematically transitioning students from school-based to work-based learning. The college's modern laboratory facilities provide a very realistic setting for gaining work experience and skill building vital to students when they enter the real-world environment. To illustrate the importance of this phase of instruction, we provide the following excerpt from our field notes:
The lesson started with the instructor asking students what they had experienced the day prior in the clinical setting, assisting them to make a direct connection between work-based and school-based learning. Several students eagerly shared their previous day's experiences. Then, the students were divided into four teams of four to five and asked to review the theoretical information they had just received in the previous hour in a large lecture-led class. Each of the teams was led by a CSCC nursing instructor and the students were encouraged to share ideas, ask questions, and experiment with care-giving skills. This highly individualized yet small-group team approach seemed to provide an exceptionally strong linkage of theory to practice. Even though students were obviously nervous about having to demonstrate their skills, they were also enthusiastic about getting the opportunity to do what nursing professionals really do. Students asked the instructor about how they might handle a particular situation when they would have to perform the skill in a clinical setting, with real-live patients. Throughout, the instructors provided support and guidance for the students as they tried out their new skills and knowledge. At the same time, students showed respect for the highly personalized instruction they were receiving.
The third phase of teaching and learning crucial to nursing preparation is the clinical phase. In this phase, students receive hands-on work-based learning experiences in real health-care facilities. Students gain experience with patients of all ages and in a variety of settings. The clinical experience provides the opportunity for students to meet an important objective of the program which is that "through the competency of technical skills, the utilization of knowledge, and the development of a sense of judgment and responsibility, the Columbus State Community College graduate nurse provides nursing care to promote an optimal level of wellness in clients." (More on the clinical phase in the next section on the work-based learning component.)
It is very important for readers to note that these three phases of the teaching and learning process are fully integrated and operating concurrently. What this means is that from the beginning of the Nursing Technology Program, all three modes of instruction--didactic, laboratory/simulation, and clinical--are evident. Unlike work-based learning programs that reserve actual practice in real-world work settings to the conclusion of the training experience, the nursing curriculum places students into the real world from almost day one. Lectures, laboratory/simulation activities, and clinical experiences are planned so that they reinforce one another. Because of this approach, there is a necessity for very close supervision of students and a large instructional staff in comparison to the total number of students served.
Connections between theory and practice were also evident in some efforts to better integrate vocational and academic education. Although the curriculum appeared to be fairly traditional in focus (e.g., human anatomy, general microbiology, psychology), sections of these courses were designated for nursing students. In these sections, students received instruction that applied academic content fairly directly to the nursing profession. In addition, the college as a whole was advocating better integration of vocational and academic education through changes being made by faculty committees to the institution's outcomes assessment process. How these efforts were affecting the Nursing Technology curriculum was not apparent during our visit, and the faculty did not describe involvement in this particular institutional assessment activity.
Finally, to support the three-phase curriculum for the Nursing Technology Program, a computer laboratory had been established. This laboratory was the brain child of one of the faculty members, but all (including the campus administration) showed great enthusiasm for the educational technology that was being tapped into for this program. The laboratory was designed to provide students with the opportunity to practice using skills and knowledge through simulations of specific health-care problems. The laboratory was open to all students in the Nursing Technology Program, even those that were not yet admitted to the Registered Nursing Program. The students we observed in the computer laboratory were enthusiastic about this instructional mode and supportive of CSCC's developments in this area.
Work-Based Learning Component
Clinical experiences are a vital part of the preparation of any health-care professional and registered nurses are no exception. Typically, students participate in 5-18 hours of clinical experiences on a weekly basis. By the conclusion of their program of study, the CSCC nursing students are expected to have spent at least 1,000 hours in various clinical settings. The clinical experiences take place with local employers under the direct supervision of a CSCC-paid nursing instructor. Students are not paid while they participate in clinical experiences.
The rationale for clinical experiences is clearly portrayed in the following CSCC report from 1991:
Learning experiences follow a pattern in each course and throughout the program. First the theory base is presented. Then students practice with the cognitive and psychomotor skills in a protected environment on campus. This is followed by practice of skills in the clinical setting, leading to integration of material in individualizing client care. These experiences assist students to develop decision-making skills by having the theory base with which to make decisions and by providing a safe learning environment with progressively more responsibility so mastery can be attained. Weekly clinical experience gives students an opportunity for using the cognitive, psychomotor, and affective skills presented the previous week. (Columbus State Community College, Nursing Technology, 1991)
During our visit to CSCC, we visited and observed nursing students and instructors in two disparate health-care facilities. Apparent during our visits were the efforts made to directly link theory with practice, classroom learning with work-based learning. To illustrate this connection, we provide the following excerpt from our notes:
Nursing instructors do formal instruction on the hospital floor, almost like an informational briefing one would expect to see used by the military. We observed an instructor in the "briefing" with a group of beginning nursing students, many quite nervous about getting their first chance to work in a large, corporate hospital setting. During the "briefing," the instructor provided very technical information related to the unit being studied in the college classroom as well as specific advice for dealing with the patients on the floor. Students were encouraged to create an individualized plan for each patient and to tie what they observed when caring for the patients directly to their coursework using what was referred to as a "path card." This card was to be used by the students to compare a patient's diagnosis to "what the textbook says to do." (Students were not encouraged to follow the textbook blindly; rather they were asked to consider whether the information made sense and appeared accurate given what they were learning in the real world.)
In addition to this technical orientation, the instructor advised the students on how to behave while working on the floor and how to interact with the regular nurses working there. The instructor was clearly very familiar with the hospital surroundings and knew many of the personnel regularly employed on the floor. Throughout our observations, the instructor acted as a coach in her interaction with the students, and her advice and encouragement appeared to set them at ease. In addition to this instructor, another CSCC nursing clinical liaison (adjunct faculty member) was working with another group of nursing students on the same floor. A brief interview with this liaison supported our observations that students were serious (visibly nervous in some cases) about their clinical experiences, but also receiving an invaluable part of their professional development. This nursing instructor gave CSCC very high marks for the quality of the teaching and learning process, pointing out the strengths of the practice-oriented approach used with associate degree nurses in comparison to baccalaureate degree programs.
A very important connecting activity that occurs relatively early in the program is the placement of nursing students in local clinical settings. The faculty member responsible for coordinating clinical placements was a senior member of the staff and very knowledgeable about the various participating health-care agencies involved with the Nursing Technology Program. She spoke in great detail about the health-care facilities in the local area where students were being placed. She showed a great deal of concern for providing a meaningful match between students and clinical agencies. In making the matches, she drew upon her personal knowledge of the nursing administrators and staffs in the various clinical settings. In addition, she gave careful consideration to the diverse culture of the institutions (recognizing that attention to cultural diversity is a written goal of the program). For example, she arranged for us to visit a large hospital which she described as having very experienced personnel, high-tech facilities, and a corporate-like atmosphere. Another facility she described as being small, intimate, and family-oriented. In both cases, her descriptions were right on target and persons at those hospitals knew the CSCC nursing instructors and were personally familiar with the Clinical Placement Coordinator.
One reason the clinical placements are so important to the nursing students and the program is that they are recognized as a way for employers to screen potential hires. We were told that many students begin to apply for positions at the beginning of their sixth quarter (out of seven) and, near the end of their training, employers begin to make judgments about which students they want to bring on as full-time employees. Consequently, clinical placements, especially near the end of the program, can have an impact not only on students' learning experiences but their full-time employment opportunities upon graduation. This situation places a heavy responsibility on the Nursing Technology Program and particularly the Clinical Placement Coordinator to make fair and reasonable assignments of all students throughout the training, but especially nearing a student's graduation. Apparently, having the opportunity to demonstrate job worthiness near the end of the program in a high-paying setting can have long-term economic benefits.
An advisory committee operates to support the program. Many of the representatives of the local health-care employers who also provide clinical experiences for students participate on this committee. The committee meets on a regular basis and has been very supportive of the curriculum changes made by the faculty. Related to this activity, legally binding written agreements are utilized between CSCC and the local employers (clinical agencies) to solidify clinical experiences for students. These agreements accomplish the following: (1) they ensure that faculty members have control of students along with the freedom to provide appropriate learning opportunities, (2) they ensure both parties have the opportunity to evaluate the arrangements, and (3) they provide for sufficient time to outplace students if a relationship is terminated. The faculty conduct periodic review of the clinical agencies, and the contributions of various agency resources, facilities, and services are routinely discussed among the faculty.
Several strengths are evident in the Nursing Technology Program. The faculty and administration are highly qualified, caring instructors who work hard to keep their curriculum up-to-date in a rapidly changing technical field. The main campus of CSCC where the Nursing Technology Program is housed has modern classroom and laboratory facilities, including the computer laboratory designed specifically for nursing students. External to the campus, Columbus provides a rich environment of diverse health-care providers of all types, ranging from the large, corporate hospital to the ultra-modern extended care facility, to the small, private clinic. Along with this diverse health-care community comes a wealth of health-care teaching institutions. In no way is CSCC acting alone in the central Ohio area in the preparation of registered nurses. To the contrary, the competition among health occupations programs in educational institutions is fierce. While this competition has its drawbacks, it also has the benefit of helping programs of high quality to remain viable. This benefit was given repeatedly by CSCC faculty who were optimistic about maintaining a market niche for their program in the changing health-care market in Columbus.
Another extremely important strength of the Nursing Technology Program is the three-phase instructional process that provides a very meaningful and real connection between theory and practice. By operating the pedagogical processes of lecture, laboratory/simulation, and clinical experience concurrently, students participate in a sort of reciprocal learning process that closely connects knowledge and skills valuable across all of these environments. Multiple teaching strategies were employed by the faculty to make the connections, including linking textbook reading assignments, laboratory exercises, "briefings," and patient care activities. Tools such as the "path card" provide students with documentation of what they've learned and practiced across the different settings. We viewed this pedagogical process as an extremely valuable model for transitioning students from school to work.
Of course, operating a program such as nursing is not easy, and one of the most serious concerns for many two-year colleges is cost. The high costs of maintaining the Nursing Technology Program were an ongoing issue for CSCC and the college administration; however, the President expressed a commitment to continuing to support the program if costs were kept within acceptable limits and as long as quality standards were maintained as well as they had been in the past. The Director of the Nursing Technology Program confirmed the President's interest in and dedication to the program and explained that she felt he had been supportive of the curriculum changes and faculty development activities she had initiated in the department. In fact, she described the President's entrepreneurial spirit as partially responsible for the success of the department and the college as a whole.
The Director described the current time as one of transition for the health-care industry as well as for the nursing profession specifically. She said that the changes were very difficult for some of the faculty, and there had been some disillusionment with the current downturn in the job market. She believed that some members of the faculty were being challenged to provide instruction in areas where they had received minimal prior training or had little previous work experience and this situation was placing increased demands on the department and college to provide professional development opportunities for the faculty. Also, the shift of teaching and learning from a more highly individualized approach to one involving teams had been difficult for some faculty. Yet, even though these changes were difficult to make on an individual basis, the Director felt they were essential for the long-term survival of the program. Modifications to curriculum were seen as vital to helping the program keep pace with what is happening in the nursing profession.
Keeping standards high and programs up-to-date with local labor market changes is crucial for any occupational program, but especially for the health-care industry. Of course, knowing how and where to change is not always obvious. Current trends in the health-care industry include dramatic downsizing of the traditional hospital facility and displacement of registered nurses with lower-paid, less-skilled nursing-related occupations (i.e., nursing technician, nursing assistant). The growth in such lower-paying occupations is creating havoc with the nursing profession. (In Columbus, for example, persons with no technical background were being trained in six weeks [often by the hospitals themselves] as nursing assistants to assume many of the duties that were once performed by professional nurses. These persons were being paid $6 per hour, whereas an entry-level registered nurse would be paid $13 to $14 per hour.)
A restructuring of work responsibilities seems to be creating many more lower-paid positions who report to fewer nursing professionals, mostly for the purposes of cutting costs. Unfortunately, the guidelines and standards set by the state and national nursing boards do not seem to be keeping pace with these changes. Consequently, educational programs such as the one at CSCC are operating with little direction from the profession. Some of the nursing instructors at CSCC are disillusioned about what they see happening to their own profession. The curricular decisions these nursing educators are being asked to make in response to labor market changes require deep-seated value judgments that get at the core of their professional lives. These are not easy decisions because they have long-term implications for the profession itself. However, a commitment to providing high-quality nursing education is evident at CSCC, and we were convinced the faculty there would ultimately make the kinds of decisions that would be most beneficial to their students.