Education Papers & Publications

Nursing Education Papers

The following are NCSBN education papers that have been written and approved since 2002, by the NCSBN Board of Directors and all NCSBN voting members at our Delegate Assembly. The papers are listed in the order they were adopted.

Nursing Education Publications

The following is a list of articles and book chapters written by NCSBN staff and members found in NCSBN's journal and other journals and books.

Transition to practice in hospital settings

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Year
2015
Authors
Maryann Alexander, PhD, RN, FAAN Jane Barnsteiner, PhD, RN, FAAN Mary A. Blegen, PhD, RN, FAAN Lou Fogg, PhD Mary R. Lynn, PhD, RN, FAAN Josephine Silvestre, MSN, RN Nancy Spector, PhD, RN, FAAN Beth Ulrich, EdD, RN, FACHE, FAAN
Description
Citation
Spector, N., Blegen, M.A., Silvestre, J., Barnsteiner, J., Lynn, M.R., Ulrich, B., Fogg, L. & Alexander, M. (2015). Transition to practice in hospital settings. Journal of Nursing Regulation, (5(4), 24-38.

The National Council of State Boards of Nursing transition to practice study: Implications for educators

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Year
2015
Authors
Nancy Spector, PhD, RN, FAAN
Description
Citation
Spector, N. (2015). The National Council of State Boards of Nursing transition to practice study: Implications for educators. Journal of Nursing Education, 54(3), 119-120.

NCSBN simulation guidelines for prelicensure nursing programs

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Year
2015
Authors
Maryann Alexander, PhD, RN, FAAN Carol F. Durham, EdD, RN, ANEF, FAAN Janice I. Hooper, PhD, RN, FRE Pamela R. Jeffries, PhD, RN, FAAN, ANEF Nathan Goldman, Suzan Kardong-Edgren, PhD, RN, ANEF, CHSE Karen S. Kesten, DNP, APRN, CCRN, PCCN, CCNS, CNE Nancy Spector, PhD, RN, FAAN Elaine Tagliareni, EdD, RN, CNE, FAAN Beth Radtke, Crystal Tillman, DNP, RN, CPNP
Description
Citation
Alexander, M., Durham, CF, Hooper, J.I., Jeffries, P.R.,Goldman, N., Kardong-Edgren, S., Kesten, K.S., Spector, N., Tagliareni, E., Radtke, B & Tillman, C. (2015). NCSBN simulation guidelines for prelicensure nursing programs. Journal of Nursing Regulation, 3(6), 39-42.

Preceptor support in hospital transition to practice programs

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Year
2015
Authors
Jane Barnsteiner, PhD, RN, FAAN Mary A. Blegen, PhD, RN, FAAN Mary R. Lynn, PhD, RN Nancy Spector, PhD, RN, FAAN Beth T. Ulrich, EdD, RN, FAAN
Description
Citation
Blegen, M.A., Spector, N., Ulrich, B.T., Lynn, M.R., & Barnsteiner, J. (2015). Preceptor support in hospital transition to practice programs. JONA, 45(12), 642-649.

A Multisite study on graduate registered nurse transition to practice program: Return on Investment

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Year
2017
Authors
Mary Blegen, PhD, RN, FAAN Tricia Johnson, Josephine Silvestre, MA, RN Nancy Spector, PhD, RN, FAAN Beth Ulrich, EdD, RN, FAAN
Description
Citation
Silvestre, J.H., Ulrich, B.T., Johnson, T., Spector, N. & Blegen, M.A. (2017). A multisite study on graduate registered nurses transition to practice program: Return on investment. Nursing Economic$: The Journal for Health Care Leaders, 35(3), 110-118.

Newly Licensed RN retention: Hospital and Nurse Characteristics

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Year
2017
Authors
Jane Barnsteiner, PhD, RN, FAAN Mary A. Blegen, PhD, RN, FAAN Mary R. Lynn, PhD, RN Nancy Spector, PhD, RN, FAAN Beth T. Ulrich, EdD, RN, FAAN
Description
Citation
Blegen, M.A., Spector, N., Lynn, M.R., Barnsteiner, J. & Ulrich, B.T. (2017). Newly licensed RN retention: Hospital and nurse characteristics. JONA, 47(10), 508-514.

A Collaborative Model for Approval of Prelicensure Nursing Programs

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Year
2017
Authors
Nancy Spector, PhD, RN  Susan L. Woods, PhD, RN, FAAN
Description
Currently, boards of nursing (BONs) use seven different models for approving nursing programs, and nursing education rules and regulations in BONs are not consistent across jurisdictions.  In 2010, the National Council of State Boards of Nursing’s (NCSBN) Board of Directors convened a committee to assess the state of prelicensure nursing program approval in BONs and to make recommendations to the NCSBN’s board based on current and future needs.  This article describes the committee’s collaborative engagement with national accreditors and the recommendations that resulted.
Citation
Spector, N. & Woods, S.L. (2013). A collaborative model for approval of prelicensure nursing programs. Journal of Nursing Regulation, 3(4), 47-52.

Guidelines for Using Electronic and Social Media: The Regulatory Perspective

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Year
2012
Authors
Nancy Spector, PhD, RN Dawn M. Kappel, MA 
Description
Social media can be a very effective way of communicating in nursing, but guidelines for appropriate use by healthcare providers are essential. This article briefly introduces the phenomenon of social media and introduces three actual scenarios where nurses unintentionally violated appropriate use of social media in healthcare. The scenarios are discussed related to social media, career, concerns, and nursing regulation. Incorporating these and other examples with data from board of nursing cases, the nature of complaints against nurses is explored as well as common myths and misunderstandings about using social media platforms. Guidelines for appropriate use by nurses and available resources to inform policy are highlighted. Next steps in social media in nursing should include development of organizational level policies and educational programs on the use of social media.
Citation
Spector, N. & Kappel, D. (September, 2012). Guidelines for using electronic and social media: The regulatory perspective" OJIN: The Online Journal of Issues in Nursing. 17(3), Manuscript 1.

The Initiative to Advance Innovations in Nursing Education: Three Years Later

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Year
2012
Authors
Nancy Spector, PhD, RN Susan Odom, PhD, RN
Description
Calls for innovation in nursing education have been prevalent in recent years.  In 2009, the Innovations in Education Regulation Committee, convened by the National Council of State Boards of Nursing (NCSBN), worked collaboratively with other stakeholders to identify perceived and real barriers to innovation in nursing education and proposed model rules and statute language that boards of nursing could adapt to foster innovations in their state’s nursing programs.  The model language was unanimously adopted by NCSBN’s Member Boards.  Since then, NCSBN has conducted three surveys to determine the impact of NCSBN’s initiative as well as the state of innovations in nursing education.  Following a review of the committee’s work, this article presents survey data on innovation in nursing education over the last 3 years.
Citation
Spector, N & Odom, S. (2012). The initiative to advance innovations in nursing education: Three years later. Journal of Nursing Regulation, 3(2), 40-44.

New Graduate Transition into Practice: Improving Quality and Safety (Chapter)

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Year
2012
Authors
Nancy Spector, PhD, RN Beth Ulrich, EdD,. RN, FACHE, FAAN Jane Barnsteiner, PhD, RN, FAAN
Description
There is evidence linking improved patient care to standardized transition to practice programs in the areas of safety, competence, and retention.  This chapter explores that evidence, presents a standardized model as a solution, and gives examples of transition program models, as well as an overview of NCSBN’s Transition to Practice model.
Citation
Spector, N., Ulrich, B.T. & Barnsteiner, J. (2012). New graduate transition into practice: Improving quality and safety. In G. Sherwood & J. Barnsteiner (Eds.), Quality and safety in nursing: A competency approach to improving outcomes (267-287). United Kingdom: Wiley-Blackwell.

Transition to Practice: An Essential Element of Quality and Safety (Chapter)

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Year
2012
Authors
Nancy Spector, PhD, RN
Description
This chapter describes the importance of transitioning new graduate nurses to practice, and the impact of such transitions on patient care.
Citation
Spector, N. (2012). Transition to practice: An essential element of quality and safety. In Amer, Kim, Quality and safety for transformational nursing: Core competencies. New Jersey: Pearson Publishers.

What Nurse Educators Should Consider When Developing Social Media Policies

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Year
2012
Authors
Nancy Spector, PhD, RN
Description
Social media offers many opportunities to promote student engagement and interactivity; however, student nurses must be instructed in the appropriate use of this tool.  It is important for nursing programs to develop sound policies related to social media.  This article suggests social media policy guidelines and presents several tools for nurse educators to utilize while implementing their own policies.
Citation
Spector, N. (2012). What nurse educators should consider when developing social media policies. Dean’s Notes. 34(1), 1-2.

National Council of State Boards of Nursing's Transition-To-Practice Regulatory Model (Chapter 10)

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Year
2011
Authors
Nancy Spector, PhD, RN Josephine H. Silvestre, MSN, RN ( JHS)
Description
This chapter gives an overview of NCSBN’s Transition to Practice model.
Citation
Spector, N. & Silvestre, J. (2011). National Council of State Boards of Nursing's transition-to-practice regulatory model. In D. Molinari & A. Bushy (Eds.), Rural nurse: Transition to practice (123-134). New York: Springer.

Quality of Care and Patient Safety: The Evidence for Transition-To-Practice Programs (Chapter 3)

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Year
2011
Authors
Nancy Spector, PhD, RN Josephine H. Silvestre, MSN, RN ( JHS)
Description
This chapter reviews the evidence for the need to transition new graduates into competent and safe nurses.
Citation
Spector, N. & Silvestre, J. (2011). National Council of State Boards of Nursing's transition-to-practice regulatory model. In D. Molinari & A. Bushy (Eds.), Rural nurse: Transition to practice (34-56). New York: Springer.

Nurses and Social Media: Regulatory Concerns and Guidelines

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Year
2011
Authors
Rene Cronquist, JD, RN Nancy Spector, PhD, RN
Description
Social Media possess tremendous potential for strengthening professional relationships and providing valuable information to health care consumers.  However, the inappropriate use of social media by nurses is causing concern among educators, employers, and regulators, and nursing organizations are beginning to develop guidelines.  When using social media, nurses must protect the patient’s rights to privacy and confidentiality and consider the potential effects of their communications on their patients, their employers, their profession, and themselves.  This article describes the professional, ethical, and legal implications of using social media inappropriately and provides guidelines from the National Council of State Boards of Nursing for using them appropriately.
Citation
Cronquist & Spector (2011). Nurses and social media: Regulatory concerns and guidelines. Journal of Nursing Regulation, 2(3), 37-40.

Are We Pushing Graduate Nurses Too Fast? Agency for Healthcare Research and Quality Mortality and Morbidity Rounds

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Year
2011
Authors
Nancy Spector, PhD, RN
Description
How do newly licensed RNs transition from an educational environment to practice to assure safe patient care?  This article examines a case study that highlights this issue, and discusses indicators that support a standardized transition to practice program for all newly licensed nurses.
Citation
Spector, N. (2011). Are we pushing graduate nurses too fast? Agency for Healthcare Research and Quality Mortality and Morbidity Rounds. Accessed from: http://www.webmm.ahrq.gov/case.aspx?caseID=238.

Use of Simulation in Nursing Education: National Survey Results

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Year
2010
Authors
Jennifer Hayden, MSN, RN
Description
While simulation in nursing programs continues to increase, it is important to understand the prevalence of this new technology in nursing education, how this technology is utilized, and how educators are preparing to teach with this educational tool.  This article reports on the results of a survey conducted by the National Council of State Boards of Nursing of 11,060 pre-licensure nursing programs in the United States as a means of describing use of simulation.  
Citation
Hayden, J. (2010). Use of simulation in nursing education: National survey results. Journal of Nursing Regulation, 1(3), 52-57.

A Regulatory Model for Transitioning Newly Licensed Nurses to Practice

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Year
2010
Authors
Nancy Spector, PhD, RN Marcy Echternacht, MS, RN
Description
This article discusses the importance of developing a national, standardized program, implemented through regulation, for transitioning all newly licensed nursing graduates to practice.
Citation
Spector, N. & Echternacht, M. (2010). 2009 update on the National Council of State Boards of Nursing’s regulatory model for transitioning new nurses to practice. JONA’s Healthcare Law, Ethics, and Regulation, 12(1), 12-14.

Evidence-Based Nursing Regulation: A Challenge For Regulators

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Year
2010
Authors
Nancy Spector, PhD, RN
Description
These are complex times for regulators on nursing boards, particularly in three areas.  First, they must stay abreast of emerging practice issues emanating from technological advances, systems thinking, a more diverse patient population living longer with multiple chronic illnesses, and a national focus on patient safety and error prevention.  Second, there has been a national call for the transformation of nursing education, and nursing boards are seeing increasing numbers of substandard or fraudulent nursing education programs.  This adds to the boards’ workload.  Third, disciplinary activity involving nurses has increased during the last 10 years, forcing regulations to stay on their toes regarding disciplinary action and investigation.  In this challenging climate, the time is ripe to focus on evidence-based regulation as a strategy for making quality decisions related to regulation.
Citation
Spector, N. (2010). Evidence-based nursing regulation: A challenge for regulators. Journal of Nursing Regulation, 1(1), 30-36.

2009 Update on the National Council of State Boards of Nursing’s Regulatory Model for Transitioning New Nurses to Practice

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Year
2010
Authors
Nancy Spector, PhD, RN Marcy Echternacht, MS, RN
Description
This article outlines the background of NCSBN’s Transition to Practice initiative and the development of the Transition to Practice Model.
Citation
Spector, N. & Echternacht, M. (2010). 2009 update on the National Council of State Boards of Nursing’s regulatory model for transitioning new nurses to practice. JONA’s Healthcare Law, Ethics, and Regulation, 12(1), 12-14.

A Transition To Practice Regulatory Model: Changing the Nursing Paradigm

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Year
2009
Authors
N. Spector
Description
This article discusses the factors that inspired a call for an evidence-based regulatory model for transitioning new nurses to practice, and gives an overview of the Transition to Practice model being developed by NCSBN.
Citation
Spector, N. (2009). A transition to practice regulatory model: Changing the nursing paradigm. Dean's notes, 31(2), 1-3.

Approval: National Council of State Boards of Nursing

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Year
2009
Authors
N. Spector
Description
This chapter takes the reader through the inception and process of professional regulation, highlighting distinctions and overlap between accreditation and approval.  Rationale and preparation for site visits are detailed, along with the recently written Model Nursing Practice Act.
Citation
Spector, N. (2009). Approval: National Council of State Boards of Nursing. In Caputi, L. (Ed.), Teaching Nursing: The Art and Science, Vol. 3 (2nd ed.). Glen Ellyn, Illinois: College of DuPage Press.

Transition to Practice: Improving Patient Outcomes

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Year
2009
Authors
N. Spector
Description
This chapter examines the evidence that a standardized transition program for new graduate nurses has a positive impact on patient safety.
Citation
Spector, N. (2009). Transition to Practice: Improving Patient Outcomes. In Caputi, L. (Ed.), Teaching Nursing: The Art and Science, Vol. 3 (2nd ed.). Glen Ellyn, Illinois: College of DuPage Press.

Regulation Fosters Innovations in Nursing Education

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Year
2009
Authors
N. Spector
Description
Because of the complexities in nursing and healthcare delivery and a national focus on patient safety, there has been a call across nursing organizations and healthcare organizations for more innovation in nursing and healthcare education.  The National Council of State Boards of Nursing held an invitational roundtable, involving representatives from nursing education organizations, boards of nursing, the American Nurses Association, and the Robert Wood Johnson Foundation.  Topics of discussion included the meaning and implications of innovation in nursing education, perceived barriers to innovation, and the future of innovation.  This article summarizes the outcomes of the roundtable’s discussion.
Citation
Spector, N. (October-December 2009). Regulation fosters innovations in nursing education. JONA’s Healthcare Law, Ethics and Regulation. 11(4), 116-119.

Clinical Education and Regulation (Chapter)

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Year
2009
Authors
N. Spector
Description
This chapter explores in detail the regulatory perspective on clinical education in nursing and why boards of nursing take the position that nursing programs need to provide supervised clinical experiences for their students.  Some of the myths about regulatory barriers are dispelled, and some of the differences among boards are discussed.  Current issues, such as the regulatory perspective on simulation in prelicensure programs and the use of exit exams are also explored.  The importance of the collaboration between education, practice and regulation is integrated throughout.
Citation
Spector, N. (2009). Clinical education and regulation. In Valiga, T. & Ard, N. (Eds.),Clinical Nursing Education: Current Reflections. New York: National League for Nursing Press.

Regulatory Recommendations for nursing faculty qualifications

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Year
2009
Authors
N. Spector
Description
The NCSBN Board of Directors charged an NCSBN committee with reviewing and presenting recommendations for future faculty qualifications and roles.
Citation
Spector, N. (2009). Regulatory recommendations for nursing faculty qualifications. JONA’s Healthcare Law, Ethics, and Regulation. 11(2), 54-56. 

Interprofessional collaboration: A nursing perspective. (Chapter 6)

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Year
2009
Authors
N. Spector
Description
The book addresses the importance of interprofessional collaboration, while this chapter presents interprofessional collaboration from a nursing standpoint.  While this may seem counterintuitive, it is understood that each discipline approaches collaboration from its own perspective, and understanding these perspectives is crucial to the success of interprofessional collaboration.
Citation
Spector, N. (2009). Interprofessional collaboration: A nursing perspective. In Collaboration across the Disciplines in Health Care. In Freshman, B., Rubino, L. & Reid-Chassiakos, Y. (Eds.), MA: Jones and Bartlett Publishers. 

Development of a standardized medication assistant curriculum

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Year
2007
Authors
M. Doherty N. Spector
Description
The National Council State Boards of Nursing took the position in their 2004 Model Nursing Practice Act and Model Administrative Rules, Article XVIII, Chapter 18, that if jurisdictions use medication assistants, they should be regulated by Boards of Nursing.
Citation
Spector, N. & Doherty, M. (2007). Development of a standardized medication assistant curriculum. JONA’s Healthcare Law, Ethics, and Regulation, 9(4), 119-124. 

A Regulatory Model on Transitioning Nurses from Education to practice

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Year
2007
Authors
S. Li N. Spector
Description
NCSBN data show that most employers reported that new graduates were not prepared to provide safe and effective care. Although educators may argue that employers are expecting too much from new graduates, this evidence supports that the gap between education and practice still exists.
Citation
Spector, N. & Li, S. (2007). A Regulatory Model on Transitioning Nurses from Education to Practice. JONA’s Healthcare Law, Ethics, and Regulation, 9(1), 19-22. 

Exit Exams: A regulatory perspective

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Year
2006
Authors
M. Alexander N. Spector
Description
A significant role for most state boards of nursing, whose mission is to protect the public, is the approval of nursing education programs in their state. As part of this process, many of the state boards review their schools’ annual pass rates of first-time NCLEX-RN candidates and compare these percentages to state regulations. Schools whose pass rates fall below the state standard risk losing the approval of their state board of nursing.
Citation
Spector, N. & Alexander, M. (2006). Exit exams: A regulatory perspective. Journal of Nursing Education, 45(8), 291-292.

Evidence-Based Health Care Seen from Four Points of View (Chapter 22)

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Year
2006
Authors
A.K Ghosh D. Stengel N. Spector F. Porzsolt
Description
Evidence-based health care (EBHC) and its approach to the practice of medicine has gained considerable acceptance among health care professionals. The Association of American Medical Colleges (AAMC) advocates integration of the principles of evidence-based medicine (EBM) into undergraduate training. Promoted as a tool to further learning by inquiry, to steer clear of opinion-based medicine (Sackett et al., 2000), and to help students at all levels of training to assess conscientiously the current best evidence, an increasing number of medical schools in the United States have incorporated it into their curriculum.
Citation
Ghosh, A. K., Stengel, D., Spector, N., Murall, N. & Porzsolt, F. (2006). Evidence-Based Health Care Seen from Four Points of View. In F. Porzsolt & R.M. Kaplan (Eds.), Optimizing health: Improving the value of healthcare delivery. New York: Springer. 

Worldviews in collision: Conflict and collaboration across professional lines

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Year
2006
Authors
A. Garman D. Leach N. Spector 
Description
The process of providing health services in hospitals is inherently interdisciplinary; many of the challenges to enhancing quality and safety involve the human aspects of this interdisciplinary system. Each of the major disciplines—physicians, nurses, allied health providers, and health administrators—represent qualitatively distinct sets of goals and professional values, influencing not only current behavior but also who chooses these roles in the first place.
Citation
Garman, A., Leach, D. & Spector, N. (2006). Worldviews in collision: Conflict and collaboration across professional lines. Journal of Organizational Behavior. 27(7), 1-21. 

Evidence-Based Nursing Education for Regulation

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Year
2006
Authors
N. Spector S. Li  K. Kenward
Description
Since Boards of Nursing are mandated to approve nursing programs, the boards are interested in knowing the evidence-based elements of nursing education that are essential for preparing new nurses for safe entry-level practice.
Citation
Spector, N, Li, S., & Kenward, K. (2006). Evidence-Based Nursing Education for Regulation. JONA’s Healthcare Law, Ethics, and Regulation, 8(3), 84-86.

NCSBN takes a stand on clinical prelicensure experiences

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Year
2006
Authors
N. Spector
Description
Recent discussion at the boards of nursing has focused on whether nursing programs leading to initial licensure can successfully educate nurses with alternative methodologies that take the place of traditional clinical experiences. Programs are asking for education rules addressing faculty qualifications to be waived and are developing programs with only limited clinical experiences with actual patients.
Citation
Spector, N. (2006). NCSBN takes a stand on clinical prelicensure experiences. JONA’s Healthcare Law, Ethics, and Regulation, January-March, 8(1), 12-14. 

Global initiatives in regulation at NCSBN

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Year
2005
Authors
K. Apple  N. Spector
Description
Recognizing the importance of the global perspective in regulation the National Council of State Boards of Nursing (NCSBN) developed as one of its 6 strategic initiatives the following: “Advance NCSBN as a key partner in nursing and healthcare regulation in the U.S. and internationally.” There are several objectives in place to meet this initiative.
Citation
Spector, N. and Apple, K. (2005). Global initiatives in regulation at NCSBN, JONA’s Healthcare Law, Ethics, and Regulation, 7(4), 112-113. 

Focus group on licensed practical nurse scope of practice at NCSBN

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Year
Authors
N. Spector
Description
The National Council of State Boards of Nursing convened a focus group to discuss the findings of the 2003 Licensed Practical Nurse/Vocational Nurse (LPN/VN) practice analysis and to make recommendations to the NCSBN board of directors.
Citation
Spector, N. (2005). Focus group on licensed practical nurse scope of practice at National Council of State Boards of Nursing. JONA’s Healthcare Law, Ethics, and Regulation, January-March, 7(1), 35-37. 

A primer: The national council of state boards of nursing nurse licensure compact

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Year
2004
Authors
K. Hellquist N. Spector
Description
The National Council of State Boards of Nursing began exploring the mutual recognition model of nurse licensure. This model, which NCSBN called the Nurse Licensure Compact (NLC), allows a nurse to have one license and to practice in other states as long as that nurse acknowledges that he or she is subject to each state’s practice laws and discipline.
Citation
Hellquist, K. and Spector, N. (2004). A primer: The national council of state boards of nursing nurse licensure compact. JONA’s Healthcare Law, Ethics, and Regulation. 6, issue 4 (October-November). 

Building a sphere of influence

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Year
2004
Authors
K. Hellquist N. Spector
Description
Individuals and organizations involved in nursing regulation, education, and practice can effectively increase their influence related to nursing regulation and improving health care in several ways.
Citation
Hellquist, K. & Spector, N. (2004). Building a sphere of influence. JONA’s Healthcare Law, Ethics, and Regulation. 6, issue 2 (April-June, 2004). 

Ethics in practice: NCLEX results to disclose or not disclose

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Year
2004
Authors
V. Sheets N. Spector
Description
Individuals and organizations involved in nursing regulation, education, and practice can effectively increase their influence related to nursing regulation and improving health care in several ways.
Citation
Hellquist, K. & Spector, N. (2004). Building a sphere of influence. JONA’s Healthcare Law, Ethics, and Regulation. 6, issue 2 (April-June, 2004). 

Regulations, Licensure and Policy Breakout Session

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Year
2001
Authors
V. Sheets
Description
The challenge to regulatory boards has always been maintaining the balance between an individual's desire to practice a chosen profession and the board's responsibility to protect the public from unsafe practitioners. Reasonable people can differ in how best to protect the public. And our boards vary in their approaches to a number of issues. I think many regulators recognize that providing access to nursing care is part of protecting the public.
Citation
Spector, N. (2004). “Regulations, Licensure and Policy Breakout Session”. In: Proceedings of the National Symposium of Students with Disabilities: Nursing Education and Practice. Chicago: Rush University Press. (Available in January, 2004).